To compare the effectiveness of nifedipine and glyceryl trjnjtrate patch jn prevention of preterm Labour

Objective: To assess the effectiveness of Nifedipine and Glyceryl trinitrate patch in prolonging the pregnancy for more than 48 hours

Methodology: This was a randomized control study. Fifty patients with preterm labour meeting the inclusion criteria were inducted in study and randomly allocated to the treatment group A [Nifedipine] and group B [Glyceryl trinitrate patch, GTN]. After taking consent from the patients, all the details were documented on a proforma and tocolysis was started with either of these tocolytics according to a preset protocol

Results: Nifedipine was found to be more effective than GTN, as prolongation of pregnancy beyond 48 hours was more frequent [74%] with nifedipine than GTN [40%] with P value <0.05 . Similarly prolongation beyond 7 days was also more frequent [32%] with nifedipine as compared with GTN [24%]. Most common adverse effect found with nifedipine was headache followed by palpitations and hypotension. GTN patch had a better side effect profile with most of the patients being asymptomatic. Fetal distress was noticed more in GTN group as compared with nifedipine

Conclusion: Nifedipine, as a tocolytic, is found to be more effective in pregnancy prolongation when compared with Glyceryl trinitrate but has frequent maternal adverse drug effects. Glyceryl trinitrate patch is well tolerated by the patients with preterm labour with relatively fewer side effects

Prevalence of domestic violence among women seeking abortion

To determine the prevalence of domestic violence in women seeking abortion. This cross-sectional study was conducted in outpatient department of Department of Obstetrics and Gynaecology, Lady Reading Hospital Peshawar, family planning Centre, Marie Stoop's society Peshawar and a private clinic from April 2012 to March 2013. Approval was taken from the ethical committee of the hospital before starting the study. A Proforma made and women seeking induced abortion that volunteered to answer the questions were included in the study. Confidentiality was maintained to avoid potential retaliation from disclosure. Domestic violence was reported by 40 [38.9%] women out of 105 women seeking induced abortion, who were interviewed consecutively. Majority of them were in stable relationship being married for more than a year [n=38, 95%]. Physical and sexual violence both were reported by 10 [25%] women each while all three types of violence i.e., verbal; physical; and sexual, were reported by 16 [40%] women. Domestic violence was reported more in spouses with lower educational status [n=22, 55%]. Violence by intimate partner was reported in 23 [57.5%] and by other family members in 7 [17.5%] cases. More than one third of the women of the sample were faced with the problem of domestic violence. Level of education was inversely related to domestic violence as it was reported more in spouses with lower educational status

Active versus conservative management of prelabour rupture of membranes at term

To compare maternal and foetal outcome of active versus conservative management of premature rupture of membranes after 37 completed weeks of pregnancy. This quasi-experimental study was carried out at Gynae unit, Lady Reading Hospital, Peshawar from September 2004 to September 2005 and included 100 patients out of which 50 were managed conservatively and 50 actively. After confirming the leakage of amniotic fluid, patients were randomized by lottery method to conservative or induced group. The patients in the group that was managed conservatively were shifted to obstetrical ward to await the onset of regular uterine activity for at least 48 hrs. After Bishops scoring, patients were induced with vaginal prostaglandin E2 tablet. Both groups received intravenous antibiotics. Total number of patients with PROM at term was 3.84%. Total cost of stay in hospital and management was greater in induced group [P. value <0.05%]. Latent time was short in induced group whereas hospital stay was prolonged in induced group. About 80% of patients in conservative group delivered by NVD as compared to 60% in induced group. Among complications mild fever and PPH were significantly [P. value <0.05] more common in conservative group. There was neither neonatal death nor stillbirth in both groups. No statistically significant difference [P. value >0.05] was observed in respect of perinatal outcome and infectious morbidity in babies. Conservative management of PROM at term should be viewed more positively for at least 48 hrs under appropriate antibiotic cover and with active management of 3[rd] stage of Labour

audit of post operative complications of elective abdominal hysterectomies

To record common post operative complications their risk factors. Obstetrics and Gynaecology unit of DHQ hospital Timergara lower Dir, from 1/01/2006 till 30/12/2006. The complications were recorded on a pre constructed Performa showing demographic data of patient, history, general health, indication for operation and surgeon rank. The Patients were divided in to three groups: A, B and C. Group - A: Complications occurring after operation with in the first 72 hours. Group - B: Complications occurring after and 12 hours but with in hospital stay Group - C: And complications recorded at follow up visit after 6 weeks. Our study showed the over all complications rate of 48.7% which is a significant rate, mortality were 4 out of 478 cases [8.36/1000]. The rate of complications was high in those women who had other associated medical problems, which can be reduced or avoided by Proper Pre-operative assessment, management and Technical factors under surgeon's control

Clinicohistological pattern of ovarian tumours in Peshawar region

Ovarian tumours are one of the major health problems confronting the general practitioners in general and gynaecologists in particular. Ovarian tumours may either be asymptomatic, found on the routine ultrasound examination or symptoms may be vague till the patient has an acute emergency like torsion or rupture of a benign cyst. The worst is late presentation of a malignant ovarian tumour. There is marked variation in the presentation of the tumour as well as in histological types. This study was undertaken to analyse modes of presentation and various histopathological patterns of ovarian tumours. This study was conducted from 1st January, 2002 to 31[st] December, 2002, in Gynaecology 'A' Unit, Lady Reading Hospital [LRH] Peshawar. After admitting patients with ovarian tumours a detailed case history was taken followed by thorough clinical examination. All the relevant details were recorded using the questionnaire. Patients were investigated after performing various surgical procedures; the specimens of ovarian tumours were subjected to Histopathological examination in the histopathology section, Lady Reading Hospital, Peshawar. Amongst the total numbers of 5732 gynaecological admissions during study period the total numbers of ovarian tumours were sixty-eight. Out of which benign ovarian tumours were 61 [89.71%] and malignant ovarian tumours were 7 [10.29%]. There were no tumours with borderline malignancy. The commonest histological pattern observed in the study was epithelial tumours [76.5%] including both benign and malignant tumours. The commonest benign tumour was serous cyst adenoma [24%] followed by mature cystic teratoma [18%]. Common malignant ovarian tumours were granulosa cell tumours and Endometriod carcinoma [each 28.5%]. Epithelial tumours are the commonest variety of ovarian tumours followed by Germ cell tumours. The histological type of ovarian tumour correlates with the prognosis of the tumour

Frequency of benign and malignant ovarian tumours in a tertiary care hospital

To find out frequency of benign and malignant ovarian tumors in a single unit in a period of one year. This was a descriptive cross sectional hospital based study conducted in Gynae 'A' Unit, Lady Reading Hospital Peshawar from 1[st] January, 2002 till 31[st] December, 2002. Patients with ovarian tumors were admitted followed by a detailed case history and thorough clinical examination. All the relevant details were recorded on a questionnaire. Patients were investigated and after performing surgery, the specimens of ovarian tumors taken were subjected to histopathological examination in the Pathology Department, Lady Reading Hospital, Peshawar. Out of the total 5732 gynecological admissions in one year research period, the total number of patients with ovarian tumors was 71 [1.2%]. Hence the frequency of ovarian tumors was found to be 12.3/1000 for all the gynecological admissions. Out of 71 cases, 61[89.71%] were benign ovarian tumors and 7[10.29%] were malignant ovarian tumors. There were no tumors determined with borderline malignancy. In three cases the histopathology reports were not reviewed. The commonest benign tumour was follicular cysts [27.86%] followed by serous cyst adenoma [24.59%]. Common malignant ovarian tumours were granulosa cell tumours and endometriod carcinoma [each 28.5%]. Ovarian tumors constitute a significant proportion of gynecological admissions with benign tumors being more frequent than malignant ones