ABSTRACT
OBJECTIVE: To determine frequency and risk factors for Cervical intra epithelial neoplasia [CIN] in patients screened with cervical cytology in gynecology outpatient department [OPD] of tertiary care hospital
STUDY DESIGN: Cross-sectional description study
PLACE AND DURATION: Gynecological outpatient department of Liaquat University Hospital Hyderabad, Sindh from July to December 2011
SUBJECTS AND METHODS: All sexually active women between age group 15 to 65 visiting to gynecology OPD who fulfilled the inclusion criteria were enrolled in the study after taking the consent. Frequency and predisposing factors for CIN were analyzed after entering in predesigned proforma
RESULTS: During study period 32 [4.5%] patients out of 700 were found positive for CIN. 297 patients [42.4%] had report positive for human papilloma virus. Mean age of patients positive for CIN were 37.5 +/- 9.4 years. Nineteen [59.4%] patients were married before 15 years of age
Twenty nine [90.6%] patients belonged to poor socioeconomic status and eleven [34.3%] patients were smoker. All patients were muslims and house wives
CONCLUSION: Though the frequency of CIN in current study was only 4.5% but infection due to human papilloma virus was much more [42.4%].Timely treatment and structured follow up of these patients can reduce carcinoma cervix in these patients
ABSTRACT
To identify the barriers in seeking definite treatment among the patients with urinary fistulae. Department of Obstetric and Gynaecology, Unit II of Liaquat University of Medical and Health Sciences Jamshoro, Pakistan. From 1[st] January 2007 to 31[st] December 2011. All patients with confirmed urogenital fistulae were included in this cross sectional study by consecutive sampling. A pre designed proforma was used to collect the information about demographic features, causes, duration of fistulae, and reasons for delay in reaching for treatment. SPSS program version 10 was used to analyze the data in terms of frequency and percentage. During the study period there were 5013 gynecology based admissions. 232 of these [4.6% of gynecological admission] were registered cases of urogenital fistulae. After the exclusion of 26 recent cases of urinary fistulae; study was carried out on 206 patients. There were 113 cases of obstetrical fistulae while 93 cases were due to iatrogenic insult during gynecological surgeries. Majority [n=164, 77%] of patients were outside from Hyderabad city. The time lapse from symptoms to presentation at treatment centre was longer than one year in patients with obstetrical fistulae, but was shorter [three to six months] in patients with iatrogenic fistula. The main barrier in seeking early treatments in cases with obstetrical fistulae was lack of knowledge about availability of treatment and treatment centre [87.6%]. Financial constraints [55.7%] and lack of attention by family [42%] were the added barriers. Regarding iatrogenic fistulae, a gross neglect of the attending surgeon was obvious. Majority of the cases were misguided about the problem [n=69, 74%]. Misdiagnosis as a case of chronic vaginal discharge was seen in eleven patients. There is a need to disseminate the awareness particularly at community levels with support of media regarding genitourinary fistulae. Fistulae should not occur but if they do, efforts should be made to shorten the time of this terrifying illness
Subject(s)
Humans , Female , Female Urogenital Diseases , Vaginal Discharge , Cross-Sectional StudiesABSTRACT
Objective: to determine frequency, knowledge, and practice of tobacco smoking in pregnant women visiting outpatient department of Liquate University Hospital Hyderabad
Study design: descriptive observational study
Subjects and methods: study carried out at Liquate University Hospital Hyderabad from 1[st] Dec 2009 to 31[st] Jan 2010. All pregnant ladies visited the outpatient department of Obstetrics and Gynecology for antenatal care with an age range 18-46 years were enrolled for study. Semi structured questionnaire consisting various items used to explore the range of knowledge and practice of pregnant women as far as tobacco smoking is concerned. Data was analyzed using SPSS version 16.0
Results: a total of 350 pregnant women were included in this study. Frequency of tobacco smoking was 60.57% [212]. 179[51.14%] women were also using smokeless tobacco along with smoking. Only 42 [12%] knew hazards of tobacco consumption .Knowledge was high in 27 [7.71%] patients. Peer pressure was the reason for commencement of smoking in 234[66.85%] of women and depression in 60[17.14%]
Conclusion: tobacco consumption is a major health problem in pregnant woman. Obstetrician should promote smoking cessation during pregnancy using evidence based methods
ABSTRACT
Objective: to evaluate risk factors, management and pregnancy outcome of patients with buterine rupture at teaching hospital
Design: prospective observational study
Setting: obstetrical and Gynecology Unit II, Liaquat University Hospital Hyderabad-Pakistan; from 1st January 2004 to 31st December 2007
Patients and methods: all patients diagnosed as case of intrapartum uterine rupture were approached. A pre-designed proforma was used to collect the demographic features, predisposing risk factors, management and feto-maternal outcome. Data fed to SPSS program version 10 to analyze the results
Results: total maternity admissions were 12678 with 11961 deliveries. A total number of 85 cases of uterine rupture were identified, giving a ratio of 0.7% or 1:141 deliveries. There were 46 cases in scarred and 39 cases with unscarred uteri. Highest incidence was found in age group 25-30 years [57.6%] and in parity group 1-3 [62.3%]. Misuse of oxytocic's [85.8%], scarred uterus [54.1%], obstructed labour [42.3%] and grand multiparty [21%] were found as main predisposing factors. Uterine repair was done in 61% of cases while hysterectomy was performed in 39% cases. Bladder repair was additionally required in 9.5% of cases. There were 6 [7%] maternal and 64 [75%] perinatal deaths due to uterine rupture
Conclusion: uterine rupture is yet a common obstetrical emergency in our area. The significant morbidity and mortality deserves our special attention by a collaborative approach. Regular antenatal checks, careful selection of patients for vaginal delivery, vigilantly monitored labour with smooth switch-over to operative delivery can reduce this drastic obstetrical complication
ABSTRACT
Objective: to observe the risk factors, clinical pattern and management of ectopic pregnancy
Design: descriptive observational study
Place and duration: gynecological Unit II, Liaquat University of Medical and Health Sciences, Hyderabad from January 1st 2006 to April 1st 2008
Patients and methods: all patients with confirmed diagnosis of ectopic pregnancy were included in the study. A pre-formed proforma was used to record the details about the demographic features, pre-existing risk factors for ectopic pregnancy, clinical features at presentation, management and findings at surgery. Data fed to SPSS program version 11 to analyses the results in terms of frequency and percentages
Results: total maternity admissions were 8016 with 62 cases of ectopic pregnancy giving an incidence of 0.8% or 1:129. Mean age was 24 years. Majority of the patients were of low parity [n=34, 54.8%]. Pelvic inflammatory disease [n=22, 35.4%], previous abdominal pelvic surgery [n=16, 26%], previous ectopic [n=4, 6.4%] and infertility [n=22, 35.4%] were seen as the major risk factors. Regarding the clinical pattern; abdominal pain, amenorrhea and collapse appeared as the common clinical presentations. All patients required surgery. Open laparotomy was performed in 56 [90.3%] cases while 6 [9.7%] patients managed laparoscopically. None of the patients found suitable for conservative or medical management. There was no maternal death related to ectopic pregnancy and the postoperative recovery was uneventful
Conclusion: the classic clinical pattern of amenorrhea and abdominal pain was lacking in most of the cases with ectopic pregnancy and there were initial diagnostic difficulties. Pelvic inflammatory disease and history of infertility were the main risk factors. Due to the delay in making diagnosis at early stage, open surgery was required in all cases. This emphasizes the importance of a thorough clinical evaluation and appropriate investigations for patients with high suspicious to benefit our poor patients by the use of recent therapeutic modalities