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Objective: This study was conducted to determine the frequency and indications of caesarian section [CS] at Combined Military Hospital [CMH] Abbottabad. Study Design: Descriptive cross sectional study. Place and Duration of Study: Obstetrics and Gynecology Department, CMH Abbottabad, from Sep 2016 to Mar 2017
Material and Methods: A total of 2, 340 females delivered during the study duration were enrolled in study. Medical records of all the patients were analyzed retrospectively to determine the CS rate. Patient's demographic data, obstetric history, and indications and type of CS were recorded. Data were entered, coded and analyzed in IBM SPSS Statistics 20 software. Descriptive statistics were produced
Results: Of 2340 births, 1093 [46.7%] were via CS with about 50.9% being emergency CS. Mean age of the patient who underwent CS was 26.7 years. The most frequently noted indication was previous CS [59.4%], followed by poor progression of labor [32.2%], and fetal distress [26.9%]. More than half of the women [57.7%] who underwent CS fell into Robson Group 5 i.e. were multiparous with at least one previous CS and had a single cephalic pregnancy at term
Conclusion: CS rate at our setting was comparable to rates at similar tertiary care hospitals in Pakistan. The most common indication was previous scar, the most frequently observed indication in literature
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Objective: This study was conducted to determine the effectiveness of Foley catheter balloon tamponade in postpartum haemorrhage at Combined Military Hospital [CMH] Abbottabad. Study Design: Descriptive study. Place and Duration of Study: Obstetrics and Gynaecology Department CMH Abbottabad, from Sep 2016 to Mar 2017
Material and Methods: Patients who developed postpartum haemorrhage after caesarean section [CS] and were treated with intrauterine balloon tamponade [IUBT] using a Foley catheter were identified by review of medical records. Patient's demographic data, obstetric history, type of CS, cause of haemorrhage and transfusion history were extracted. Data was entered, coded and analyzed in IBM SPSS Statistics software. Descriptive statistics were produced
Results: A total of 26 patients were included with mean age of 29.2 +/- 5.23 years. More than two-thirds of the patients were multi-gravida and around three-quarters were at full term. The most frequent cause for postpartum haemorrhage [PPH] was placenta previa major. In 25 of the 26 [96.1%] patients the procedure was successful in stopping bleeding. There were no adverse effects related to the procedure
Conclusion: We found that IUBT with an inexpensive Foley catheter is likely to be effective in most cases of PPH associated with caesarean section, without causing additional adverse events
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Objective: To identify risk factors predisposing to morbidly adherent placenta and to study obstetric outcome in such patients
Study Design: Retrospective descriptive study
Place and Duration of Study: Department of Obstetrics and Gynaecology Military Hospital Rawalpindi, from Jan 2014 to Dec 2014
Material and Methods: A total of 54 patients with morbidly adherent placenta were studied retrospectively. Patient's data including demographic data, previous obstetric history and outcome was collected from hospital records. Data was analyzed by using SPSS version 20
Results: The incidence of morbidly adherent placenta was 4.74 per 1000 deliveries. Mean age of patients was 33.33 +/- 2.82 years with mean gestational age of 35.13 +/- 0.91 weeks. All patients had history of prior caesarean section with 4 [7.40 percent] patients having four, 32 [59.25 percent] having three, 16 [29.62 percent] having two and 2 [3.70 percent] having one previous caesarean section. Associated placenta previa was present in 43 [79.62 percent] patients. Out of 54 patients 39 [72.22 percent] had placenta accreta, 11 [20.37 percent] had placenta percreta while 4 [7.4 percent] had placenta increta. Obstetric hysterectomy was done in 51 patients while in remaining 3 uterus was preserved. Out of these three, one died as a result of septicemia while methotrexate was started in remaining two cases. However an interval hysterectomy was performed in these two cases because of massive postpartum hemorrhage
Conclusion: Previous caesarean section and placenta previa are major risk factors for morbidly adherent placenta. Patient education, antenatal diagnosis with well planned surgical intervention and anticipation of blood loss are keys to successful management
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To determine the most common semen abnormalities and risk factors associated with different types of semen abnormalities in infertile male. Cross sectional study. This study was conducted in the Department of Obstetrics and Gynaecology, Unit B, Lady Reading Hospital Peshawar, for a period of one year from 1[st] January 2009 to 31[st] December 2009. Hundred male patients with abnormal semen analysis were recruited after fulfilling the inclusion criteria. Semi structured Questionnaire was filled and data was collected regarding association of male infertility with common risk factors. Results were expressed in percentages. Descriptive statistics was applied using Microsoft Excel and the frequency and percentages were calculated. Among 100 infertile male patients, 44% patients had asthenospermia, 17% had oligospermia 14% had azoospermia, 13% had pyospermia and 12% had oligoasthenospermia. Drug addiction was [cigarette or cigarette plus THS] observed in 55% [n=55] of patients. Among all participants 46% [n=46] were overweight or obese, In 40% [n=40] infertile males, there were coital problems. Systemic illness was found to be in 34% [n=34] of males with infertility, of all the participants largest number of infertile males were farmers 19% [n=19]. Asthenospermia accounted for the frequently associated problem of abnormal semen analysis followed by oligospermia, azoospermia pyospermia and oligoasthenospermia respectively. Cigarette smoking and obesity are the most frequently associated risk factors
Subject(s)
Humans , Male , Risk Factors , Infertility, Male , Cross-Sectional Studies , Surveys and Questionnaires , Oligospermia , AzoospermiaABSTRACT
Introduction: Social marketing is a key strategy to influence the health seeking behavior of human beings on a large scale. Although social marking approach is applied to address a variety of social concerns, it also has a vital role in the health promotion and disease prevention.
Objectives: 1-To elaborate the source of social marketing for the promotion of routine immunization among children under-5 years. 2-To assess the determinants of social marketing in term of promotion of routine immunization
Material and Methods: The survey was conducted in the Department of Pediatrics of the Rehman Medical Institute [RMI] Peshawar KPK over a period of two months. Self-administered questionnaire-based survey was used to address the objectives. The questionnaire catered to the four Ps [Promotion, Personnel, Partnership, and Proof] that are the basic themes of social marketing applicable for promotion of immunization. Parents of children under-5 years of age were included as subjects. Data were analyzed by using SPSS version 15.0
Results: A total of 63 parents were surveyed during two months of data collection period. About 54% of them were unaware about National immunization days. However 84% had got information about immunization, where 63% had got information from print media and perceived that the information was sufficient to convince them
Conclusion: Social marketing is an effective tool in ensuring health seeking behavior especially in immunization of under-5 year children; however health promotion activities by vaccinators, others health care professionals and governmental and non-governmental organization linked with low immunization are lacking in the region
Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Social Marketing , Surveys and Questionnaires , Awareness , School Health Services , Parents , Hospitals, Private , Child, PreschoolABSTRACT
Background: Cerebrospinal fluid [CSF] leaks can arise as a complication of trauma, hydrocephalus, endoscopic sinus surgery or it may occur spontaneously without any identifiable cause. Surgical repair is recommended in patients who do not respond to the conservative management. In recent years transnasal endoscopic approach has become the preferred method for repairing the CSF leaks and better outcomes have been reported as compared to the intracranial approaches that were previously used. Objective of this study was to analyse the outcome of transnasal endoscopic repairof CSF rhinorrhoea. Methods: This prospective study was conducted in the Department of Neurosurgery, Ayub Medical College, Abbottabad, from March 2007 to March 2010. Twenty-one patients with CSF rhinorrhoea were included in study that were diagnosed on the basis of clinical evaluation, glucose concentration of nasal discharge, computed tomography [CT] and magnetic resonance imaging [MRI]. These patients did not respond to conservative management and were operated transnasally using rigid endoscope. Patients were followed up for a mean duration of 9 months and the outcome was analysed. Results: The patients included in the study ranged in the age group of 1255 years. Among the patients 13 [57%] were female and 8 [38%] were males. The cause of CSF rhinorrhoea was traumatic in 16 [76.19%], Idiopathic or spontaneous in 4 [19.04%] and 1 [4.7%] case was related to endoscopic surgery for pituitary macroedenoma. In 10 [47.6.8%] patients the site of leak was cribriform plate, 5 [23.8%] had from sphenoid, 4 [19.04%] from frontal sinus and in 2 [9.5%] Ethmoid was affected. Primary surgery was successful in 17 [80.95%] of cases. In 2 [9.5%] cases re-exploration had to be performed. In 1 patient re-exploration had to be done for the third time. Overall success rate was 95%. One patient presented with CSF leak and meningitis 1 month after surgery and unfortunately died. Conclusion: Transnasal endoscopic repair of CSF rhinorrhoea is highly successful, safe and less traumatic. Keywords: Transnasal endoscopic repair, CSF Rhinorrhoea, CSF leak, transnasal endoscopic duroplasty
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Background: The radicular cyst is very common odontogenic cyst of the jaws, which is usually associated with a tooth with necrotic pulp. The cyst formation requires proliferation of the epithelial rest cells of Malassez present in the periodontal ligament.. Proliferation of epithelial rest cells of Malassez is an essential event in the Pathogenesis of radicular cyst. The wall of the cyst contains epithelial cells, macrophages, fibroblasts and other cells. TNF is one of inflammatory mediators, which is produced by macrophages and monocytes. This study was carried out to investigate the role of tumour necrosis factor in the pathogenesis of radicular cyst, which is by far the commonest cystic lesion of the jaws. Methods: Explants from 20 radicular cysts were cultured in vitro to grow the epithelial cells. However, the cultures were rapidly contaminated with fibroblasts and it was impossible to grow the epithelial cells separately. Therefore, the proliferative effect of Tumour Necrosis Factor [TNF] was studied on mammalian epithelial cells. Results: TNF at low concentration had a proliferative effect on the epithelial cells, which may play some role in pathogenesis of radicular cyst. Conclusion: TNF stimulated the epithelial cell proliferation in low concentration and inhibit the proliferation in higher concentrations. These two effects may have some implications in the pathogenesis of radicular cyst