ABSTRACT
Background: The Primary caesarean section [ CS] delivery worldwide rate is increasing due to public interest to avoid fetal complications and acceptance by most of the couple to complete their family with one or two children. This study was undertook to study selected cases of primary CSs in primigravid women, keeping the objectives to study the complications lead to cesarean section, maternal morbidity and mortality
Methods: Cross sectional survey conducted among Primigravidae in maternity and Pediatrics hospital -Abha - obstetrics and gynecology department between January 2016 and December 2016. Overall 170 cesarean section has been done out of 1167 births
Conclusion: Preeclampsia, eclampsia, placenta previa, intrauterine growth restriction, macrosomic fetus, malpresentation of the fetus, loss of fetal moment, fetal distress and labor dystocia are all indication of cesarean section. Our study revealed that cesarean section among Primigravidae still low in our area of the study
Subject(s)
Humans , Women , Adolescent , Adult , Middle Aged , Cross-Sectional Studies , Gravidity , Maternal Mortality , Surveys and Questionnaires , Pregnancy Complications , Delivery, ObstetricABSTRACT
Background: Little is known about the factors that influence the choice of medical specialty by male and female senior medical students at King Abdulaziz University in Jeddah so this study was conducted to investigate these factors. Methods: In this cross sectional study, data was collected through a questionnaire that was adapted to the Saudi culture from. It was distributed to three hundred male and female medical students in their sixth year and the response rate was 79.6%. Data analysis was carried out by using the Statistical Package for the Social Science (SPSS) version during the years 2013-2014. The percentages and the significances of the most and the least factors that influence the choice of medical specialties by the sample of the study were computed. Results: Study showed that 91 out of 121 senior male students and 88 senior female students out of 118 agreed that joining medical school was their first interest. Results illustrated that helping patients is the most considerable reason to choose medicine by the majority of the students (93% of senior male students and 91% of senior female students) whereas family enforcement was the least influential reason to choose medicine (28% of senior male students and 23% of senior female students). Internal medicine was chosen by the majority of the sample of the study as their first interest after graduating from medical school (43 male and female senior students). While only one male medical student chose community medicine. Conclusions: Medicine was the first choice for the majority of both male and female medical students who entered university. Internal medicine was the most desirable specialty following graduation. Most of the graduates have no plan in pursuing a career in general practice. It is advocated to establish a career advising committee at KAU. The committee should focus on medical students during their final clinical years. The lack of physicians in some specialties and its effect on the community should be addressed.
ABSTRACT
Epithelial ovarian cancer is the most common cancer of gynaecologic origin in Pakistani women. It ranks among the ten most common cancers in our women. Despite being commonly encountered, information regarding the clinicopathological features is lacking. To study the clinical and pathological features of epithelial ovarian cancer in our patients.. Department of Medical Oncology, Jinnah Hospital Lahore. Period: Jan 01,2001 to Dec 31, 2002. Patients and All patients with histological or cytological diagnosis of epithelial ovarian cancer regardless of stage were included in the study. Information was obtained from medical records which were reviewed thoroughly. Blood samples for analysis of BRCA mutations were sent to University of Toronto, Sunnybrook and Women's College Health Sciences Centre, Toronto, Canada. 75 patients were accrued. Mean age of the patients was 47 years. The well defined risk factors such as nulliparity, lack of lactation, early menarche and late menopause were not present in the majority of our patients. One striking feature was the number of patients with family history of cancer [18.7%]. Majority were first degree relatives of the patients and most had ovarian or breast cancer. BRCA1 and BRCA2 were seen in nine [12%] of the patients. Clinical presentation and histologic features were similar to American and European patients, the only difference was that a large number [88%] of our patients presented with advanced [stage III or IV] disease. Epithelial ovarian cancer manifests itself in a younger population of our women. Higher frequency of positive family history was another striking feature of Pakistani patients
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Objective: to determine the overall survival and impact of histopathological grade, residual disease and age on survival of patients with epithelial ovarian cancer
Study Design: retrospective study
Place and Duration of study: department of Medical Oncology, Jinnah Hospital Lahore, from Jan 01, 2001 to Dec 31, 2002
Patients and Methods: patients with all stages of epithelial ovarian cancer with histological documentation of the disease ·were- included- in- the- study.- Patients with malignant ascites consistent with adenocarcinoma with an ovarian mass were also included. Patients with germ cell" or stromal tumors were excluded. Patients with ovarian metastases from any other malignancy were also excluded. Survival from the date of diagnosis was the end point. Overall survival was calculated from the date of diagnosis to the date of death or the date when the patient was last known to be alive. The impact of age of the patient [< 50 yrs. vs= 50 yrs.], tumor grade [low grade vs. intermediate and high grade] and residual disease [1.5 cm] on survival was evaluated. Information was collected from medical records and a thorough review was done. The data was analyzed by SPSS. Survival was. Evaluated by the Kaplan Meier Survival plot
Results: seventy-five patients were accrued to the study. Median age of the patients was 47 years. Mean overall survival was 36 months [95% C.I, 26 to 47]. Overall 5-year survival rate was 38% .Younger age at presentation, high tumor grade and bulky residual disease are poor prognostic factors, having an adverse effect on survival in epithelial ovarian cancer. Patients with well-differentiated tumors had a mean survival of 44 months as compared to just 17 months for patients with moderate to poorly differentiated tumors [p=.002]. Patients with minimal residual disease after initial surgery had a mean survival of 52 months whereas those with bulky disease had a survival of 13 months only [p=.000]. The overall survival of patients younger than 50 years was 29 months and those older than 50 years was 39 months
Conclusion: younger age at diagnosis, high histological grade and suboptimal debulking are associated with inferior survival in patients with epithelial ovarian cancer
ABSTRACT
Aggressive non Hodgkin's Lymphomas [NHL] are common in Southeast Asia, Middle East and Africa. Data on survival with relation to prognostic factors is scarce. The primary objective of the study was to evaluate the applicability of International Prognostic Index [IPI] to predict overall survival [OS] and disease free survival [DFS] in developing countries. Two hundred and nineteen patients of NHL consecutively presenting to the Department of Oncology, Jinnah Hospital Lahore between August 1998 to July 2000 were analyzed. All patients underwent initial staging according to Ann Arbor staging system. The patients were categorized by five independent risk factors: patient age, disease stage, serum lactate dehydrogenase [LDH] levels, performance status, and number of extranodal sites involved. Patients were divided into three risk categories Low [0 or one risk factors], Intermediate [2 risk factors] and High [3 or more risk factors]. According to IPI low risk category comprised of 15%, intermediate 21% and high 64% of patients, Overall survival [OS] for 2 years and 5 years [n=197] was [69%], [51%], [32%,] and [64%], [46%], [13%] respectively [p=0.0008]. Disease free survival [DFS] for 2 years and five years [n=197] was [66%], [43%], [34%] and [66%], [43%], [18%] respectively. Age adjusted [60] DFS for 2 and 5 years [n=164] was [70%], [45%], [40%] and [63%], [45%] [19%] respectively. OS for 2 and 5 years [n=164] was [71%], [52%], [34%] and [64%], [46%],[l 1%] respectively [p=0.0013]. Conclusions: The IPI accurately predicted survival in our population. Modification of treatment protocols according to specific risk groups will be beneficial to the developing countries with limited resources