ABSTRACT
To compare the safety and efficacy of manual vaccum aspiration and sharp curettage in the treatment of first trimester abortions. Randomized controlled trial. Department of gynecology, Social Security Hospital Shahdra Lahore in collaboration with Family Health Hospital Johar Town Lahore, from May 2007 to May 20102. Six hundred women admitted with the diagnosis of first trimester less than or equal to 12 weeks abortions were randomly assigned, 300 to manual vacuum aspiration [MVA] and 300 to traditional sharp curettage. Diagnosis of abortion was confirmed by last menstrual period, physical examination and ultrasonography. In total of 600 patients, 300 randomly assigned to MVA and another 300 patients assigned to sharp curettage managemet were having mean age of 31.8 and 33 yrs respectively. mean parity was in both groups, mean gestational age 8.9 and 8.2 weeks, mean duration of procedure was 6.4 and 5.8 minutes, duration of hospital stay was 4 and 40 hrs, missed abortion in 47% and 43% patients, incomplete abortion in 53% and 57% patients, cervical dilatation was needed in 1% against 53%, 10% against 8% experienced mild pain in both groups, no patient of incomplete evacuation against 0.6%, uterine perforation in none against 0.3%, excessive bleeding was experienced by 0.3% against 0.6% patients in both groups, and patient satisfaction rate was 99% against 99.4% in the two groups respectively. in the management of first trimester pregnancy loss, MVA offers a quick solution to the problem with reduced hospital stay and lower rate of complications
Subject(s)
Humans , Female , Vacuum Curettage , Dilatation and Curettage , Pregnancy Trimester, FirstABSTRACT
To determine the frequency of adverse effects attributed to Methotrexate [MTX] toxicity and serum minimum toxic concentration with low dose MTX in Rheumatoid Arthritis [RA] patients. Cross-sectional observational study. Department of Chemical Pathology and Endocrinology, Armed Forces Institute of Pathology, Rawalpindi, from March 2010 to March 2011. One hundred and forty adult patients of RA receiving low dose MTX [10 mg/week] for at least 3 months, were included by consecutive sampling. Blood samples were collected 2 hours after the oral dose of MTX. Serum alanine transaminase and creatinine were analyzed on Hitachi and blood counts on Sysmex analyzer. Serum MTX concentration was measured on TDX analyzer. Out of one hundred and forty patients; 68 males [49%] and 72 females [51%], 38 developed MTX toxicity [27%], comprising of hepatotoxicity in 12 [8.6%], nephrotoxicity in 3 [2.1%], anaemia in 8 [5.7%], leucopenia in 2 [1.4%], thrombocytopenia in 3 [2.1%], pancytopenia in 2 [1.4%], gastrointestinal adverse effects in 5 [3.6%] and mucocutaneous problems in 3 [2.1%]. Receiver operating characteristic curve revealed serum minimum toxic concentration of MTX at cutoff value of 0.71 micro mol/l with a sensitivity of 71% and specificity of 76%. Adverse effects of low dose MTX were found in 27% of RA patients, mainly comprising of hepatotoxicity and haematological problems. MTX toxicity can be detected by therapeutic drug monitoring of serum concentration of 0.71 micro mol/l with sensitivity of 71% and specificity of 76% in the patients on low dose MTX maintenance therapy
ABSTRACT
Objective: To determine the effect of supplementaloxygen on APGAR score of newborn babies, givento pregnant ladies undergoing elective lowersegment caesarian section under spinal anesthesia
Study Design: Cohort study
Place and durationof study: Combined Military hospital Rawalpindi,from Jun 2010 to Mar 2011
Methodology: Onehundred and twenty full term pregnant ladies wereenrolled by non probability consecutive sampling,who were scheduled for elective caesarian sectionunder spinal anesthesia. The patients wererandomized into two groups [A and B]. In patientsof Group A supplementation of oxygen was given tothe mothers after spinal block, while in Group B,patients were not provided with supplementaloxygen after spinal anesthesia. Cases requiringgeneral anesthesia or supplemental oxygen [in groupB] for some other reasons causing maternal hypoxiawere excluded from the study. APGAR Score at oneminute and five minute was recorded
Results: Intotal of one twenty newborns, 56 [47%] were malesand 64 [53%] females. Mean age of the pregnantladies under study was 35 + 5 in group A and 33 + 7in group B. In group A, the value of APGAR scoreat one minute varied from 6 to 10 and, at fiveminute it was from 8 to 10. While in group B, theresults of APGAR score were same without anysignificant difference [P>0.05]
Conclusion:Supplemental oxygen has no role on the APGARscore of newborns but simple psychologicalsatisfaction to some of the mothers at the cost ofwastage of oxygen while in some patients causinganxiety, so patients should be educated on thisaspect and un-necessary use of supplemental oxygenmust be avoided
ABSTRACT
To determine the frequency of contamination of steroids in drugs prescribed by quacks, being used by patients in Rawalpindi. Cross- sectional study. Department of Chemical Pathology and Endocrinology, Armed Forces Institute of Pathology Rawalpindi, from June 2010 to March 2011. One hundred and seventy eight drugs distributed by quacks in Rawalpindi were collected from the patients. Quackery formulations [QF] were analyzed by thin layer chromatography on fluorescent Aluminum silica plates by using mobile phase of methylene chloride: ether: methanol: water [77:15:8:1.2] and relative flow of spots were noted. Samples positive for steroids were confirmed by high performance liquid chromatography. Out of In total of 178 samples, 125 [70.2%] were received by patients from unregistered hakeems, 29 [16.3%] unregistered homeopaths and 24 [13%] directly from nonmedical shopkeepers, prescribed for in joint pains 84 [47%], generalized weakness 43 [24%], dermatitis 28 [16%], gastrointestinal diseases 12 [7%] and respiratory diseases 11 [6%]. Out of 178 samples, 38 [21%] QF were contaminated with steroids found in 18 [48%] tablets, 10 [26%] powders, 5 [13%] creams, 3 [8%] capsules and 2 [5%] syrups. Out of 38 Steroid contaminated QFs 20 [53%] countrained dexamethasone, 12 [32%] prednisolone, 4 [10%] hydrocortisone and 2 [5%] betamethasone. In modern era, patients are still using drugs prescribed by quacks and 21% of QF in Rawalpindi is contaminated with steroids. The steroids comprise mainly of dexamethasone and prednisolone in adulterated tablets and powders prescribed by hakeems.