psyche of caesarean

The present study was conducted to assess psychological, social and physical impact of caesarean on a woman. It is a Cross sectional and comparative study and was conducted at department of Obstetrics and Gynaecology, Jinnah Hospital, Lahore. The study included random selection of two hundred and twelve women with recent caesarean section [within 6 weeks] admitted in the ward or presenting in out patient department of Jinnah Hospital, Lahore From January 2004 to April 2004. They were divided in two groups. Group I with one caesarean section included 124 patients and Group II with repeat caesarean sections included 88 patients. The women were interviewed according to a preset proforma. Out of the two hundred and twelve women interviewed, the age, social and educational status were comparable between the two groups. 40.3% of the patients in group I and 56.8% in group II [P value < 0.05] were apprehensive because of pain. 40.3% of group I and 50% of group II [P value > 0.05] patients were scared of immobility. 40.3% in group I and 36.4% in group II [P value > 0.05] said that they had to stay longer in the hospital. 56.5% in group I and 56.8% in group II [P value > 0.05] were afraid of anaesthesia. 27.4% in group I and 15.9% in group II [P value < 0.05] had reservations because of excessive blood loss. 9.7% in group I and 18.2% in group II didn't like caesarean section because of risk of infection [P value > 0.05]. 38.7% in group I and 40.9% in group II felt bad of scar in the abdomen [P value > 0.05]. 37.1% in group I and 31.8% in group II [P value > 0.05] had social pressures. 58.1% in group I and 56.8% [P value > 0.05] in group II had problems with care of the neonate [Feeding]. 4.0% of group I and 6.8% [P value > 0.05] of group II patients had mild psychological problems like anxiety and postpartum blues, which settled with psychological support and anxiolytics. 35.5% of group I and 28.4% of group II [P value > 0.05] had fears about future fertility. 25.8% in group I and 40.9% [P value < 0.05] in group II did not mind having caesarean in next pregnancy. Although there are some fears in the minds of women about caesarean section, the common problem are benign and manageable, they can be alleviated through counseling and better care. Larger studies are required to assess each variable independently

Subcuticular versus interrupted skin closure in appendectomy

A comparative study of skin closure technique in patients undergoing appendicectomy is presented. Fifty patients operated for uncomplicated [non gangrenous, non perforated] acute appendicitis were randomly divided in two groups. In one group the skin wound was closed with simple interrupted stitches while the other group underwent a subcuticular closure. The average skin closure time in first group was 3 min and in the other it was 4.5 min. The patients in Subcuticular closure group needed less post op analgesia, and were more pleased with the scar. The wound infection rate in both groups was same [4%]. We recommend Subcuticular closure in appendicectomy because of better cosmesis, with no added risk of wound infection