Bacterial vaginosis; comparison of vaginal metronidazole with vaginal clindamycin in the treatment of bacterial vaginosis

Bacterial vaginosis is the most common vulvovaginal infection and represents the 35% of all the infections occurring in women in the reproductive age. Serious forms of can induce several complications such as spontaneous preterm labour and preterm birth, late miscarriage and postpartum endometritis, PID, infertility, vaginal cuff infection and postabortal sepsis. To compare the efficacy of vaginal metronidazole and vaginal clindamycin in the treatment of bacterial vaginosis. Interventional: Quasi experimental study. Obstetrics outpatient department, Ghurki Trust Teaching Hospital, Lahore. Six months i.e. from 01-01-2009 to 30-06-2009. Mean age of patients was found to be 24.33 years. In the 100 patients enrolled, no statistically significant difference was found between Clindamycin 2% vaginal creams compared with metronidazole 0.75% vaginal gel using Amsell's criteria. Metronidazole has a failure rate of 13% while failure rate was 6% in the clindamycin group. A 3 day regimen of clindamycin 2% vaginal cream was as effective as 5 day regimen of metronidazole 0.75% vaginal gel in the treatment of bacterial vaginosis

Abnormal cervical smear; colposcopy and outcome of cervical biopsy

To evaluate the colposcopic findings and biopsy results in patients with abnormal cervical smear reports. Study Interventional-Quasi experimental study. Department of Obstetrics and Gynecology, Unit-I, Services Hospital, Lahore. Period: Six months [June 21, 2007 to December 20, 2007]. Fifty patients were included according to inclusion criteria. Mean age of the patients was found to be 32.8 +/- 7.3. Maximum patients were>para 4. 44% pap smears were with grade-II dyskaryosis. 41 patients were found with acetowhite area, their biopsy findings showed 24.5% CIN-II cases. Same results were found in iodine negative areas and biopsy in mosaic pattern showed 25% cases. Cervical cancer is a cause of morbidity and mortality among gynecological malignancies, but with the help of non invasive technique like colposcopy it can be detected in its earlier stages where definitive cure is possible

Septicemia; As a sequel of induced miscarriage

lnduced Miscarriage is defined as the elective termination of pregnancy before 24 weeks of gestation. To determine the frequency of sepsis associated with induced Miscarriage. Cross-sectional survey. Department of Obstetrics and Gynaecoiogy, Unit-II, Ghurki Trust Teaching Hospital, Lahore. Six months from 25-12-08 to 24-06-09. Total 110 cases were taken. Complete history including parity and mode of admission was taken. All information was recorded on specially designed proforma. A large number of patients turned out to be para 3-4 i.e. 87 [79%], 15 cases [13.7%] had the parity between 5-7 and only 8 cases [7.3%] were para 1-2 [Table-l]. 0n analyzing the mode of admission it was found that 50 [45.4%] patients were admitted through out-patient department. 60 cases [54.6%]were admitted through emergency [Table-ll]. Finally the frequency of sepsis amongst women presenting with Miscarriage was calculated and it was found to be 25 [22.7%]. 85 [77.3%] cases did not show any evidence of sepsis [Table-lll]. Illegal Miscarriages are a major contribution to septic morbidity leading to a large number of maternal deaths which is a dilemma in under developed countries like ours. Better public awareness and access to contraceptive measures has a definite role to play in improving the outcome.

Effectiveness of transdermal glyceryl trinitrate patch

To determine the effectiveness of transdermal patch of glyceryl trinitrate as tocolytic agent. Interventional- Quasi experimental study. Department of Obstetrics and Gynecology Unit- 1, Services hospital, Lahore. One year [February 10, 2006 - February 10, 2007]. Fifty pregnant women with preterm labour were included in the study. 54% of pregnant women were between G2 - G4. Majority [48%] of the women presented between 31 - 34 weeks of gestation. 46% of pregnant women had bishop score of 4 or more. 64% of patients found to have no risk factor for preterm labour. Majority [86%] responded after application of second patch [10 mg glyceryl trinitrate patch]. 84% had no side effects. Local skin reaction [10%] and headache [4%] observed in few patients. 58% of pregnant women delivered after 48 hours and 78% of them delivered vaginally which was statically significant and majority of babies delivered weight more than 1.5 kg and with good Apgar score. It is concluded from the study that glyceryl trinitrate is a safer tocolytic, which has simple method of application; rapid onset of action with low cost, low risk from side effects and it does not require intensive monitoring