Comparison of single dose versus multiple doses of antibiotic prophylaxis in elective caesarian section

To compare the efficacy of single dose verses multiple doses of antibiotic [cefotaxime] in the prophylaxis of postoperative wound infection in elective caesarian section. This quasi experimental study was conducted in the Department of Obstetrics and Gynecology, Lady Reading Hospital Peshawar from 1[st] January to 31[st] Dec 2007. Hundred patients admitted for elective caesarian section fulfilling selection criteria were included in the study through non probability convenience sampling. These were randomly allocated by card method into 2 groups of 50 each. Patients were operated by specialist registrar and Group A was given single dose of prophylactic antibiotic while group B was given multiple doses. Wound was examined on 2nd and 6[th] day and then after 6 weeks. The efficacy was measured in terms of febrile morbidity; infection and duration of hospital stay. All data were entered in a semi structured proforma. Statistical analysis was carried out by using Chi Square test. Febrile morbidity was equal in both groups [n=10, 20%]. Superficial wound infection was [n=8, 4%] in both groups. Deep wound infection was [n=2, 1%] in group A and [n=4, 2%] in group B and duration of hospital stay was equal in both groups. Nonsurgical site infection occurred in [n=16, 8%] in group A and [n=12, 6%] in group B. There was no significant difference in outcome between the two groups. Single dose antibiotic [cefotaxime] is as effective as multiple doses of antibiotics [cefotaxime] in the prophylaxis of postoperative wound infection in elective caesarian section

misplaced in intrauterine contraceptive device recovered from urinary bladder

The case report describes successful removal of misplaced Intrauterine Contraceptive Device [IUCD] from urinary bladder. X-ray and ultrasound of the pelvis showed IUCD to be lying outside the uterus and on laparotomy IUCD was removed from urinary bladder

use of vaginal misoprostol to terminate the pregnancy in second trimester

To determine the effectiveness of vaginal Misoprostol for the second trimester termination of pregnancy. Prospective randomized trial. This study was carried out in the Unit of Post Graduate Medical Institution Peshawar I aJv Reading Hospital Peshawar from 1[st] January till 31[st] December 2006. A total of 100 patients were included in this study. Misoprostol 400 microgram, was dministered intra-vaginally and repeated after every 4 hours up to a maximum of five doses or until the termination of pregnancy, which ever was earlier. The exclusion criteria were as allergy to prostaglandin, a previous classic caesarean section or Hysterectomy, active vaginal bleeding, severe asthma and epilepsy. Period of gestation ranged from 12 to 20 weeks, Indications for 2' trimester termination of pregnancy .ere chromosomal or structural fetal anomalies [anencephaly] whether dead or alive, missed abortion intrauterine fetal death. Success rate at 48 hours was 90%. The median induction to termination interval was 16 hours. Few Aomen suffered gastrointestinal side effects such as nausea [6%], vomiting [3%] and diarrhea [1%]. 400 Microgram of Vaginal Misoprostol is highly effective way of cervical ripening and termination of second trimester pregnancy

Pregnancy after B-Lynch suture and uterine artery ligation in case of placenta increta

This case report describes successful pregnancy outcome following B-Lynch suture and bilateral uterine artery ligation to control bleeding from placental bed in case of placenta increta