Preoperative information and informed consent in patients undergoing elective surgery at Isra university hospital, Hyderabad

The purpose of this study was to assess the patient's awareness of informed consent and to evaluate the current practice of obtaining informed consent from patients proposed for elective surgery in tertiary care hospital. Cross sectional survey. This study was conducted in Isra University Hospital, Hyderabad, Sindh from 2[nd] April 2012 to 3[rd] March 2013. This study was designed as an observational investigation and no interference was made regarding the informed consent process to the patient. The selection criteria for the patients who were interviewed were convenience sampling. All adult patients of >18 years, who were undergoing various surgical procedures were interviewed after taking verbal informed consent on the second postoperative day, when they were comfortable to answer the questions. While all those patients who were uncomfortable due to pain or other reason and were unwilling to answer the questions were excluded from the study. All the patients were asked predesigned questions related to the information they were provided before the surgery as part of standard informed consent practice. Questions were asked in local language which includes the demographic data, operative details, risk, benefit, complications of surgery, type of anesthesia and alternative treatment options etc. The data was entered on SPSS version 16. Frequency and percentages were calculated to show the results. Mean age of the patients was 34.95 +/- SD 14.236 years. 220 patients were included in the study. 183[83.18%] patients were told about the indications of surgery while 136 [61.81%] patients were not told about any complication of Surgery. Type of anesthesia was discussed in only 25[11.36%] of patients while complications of anesthesia were discussed in only 18[8.18%] of patients. 165[75%] patients were not given time to ask the questions regarding their disease or surgery. Consent by the consultants was taken in only 63[28.63%] patients. The majority of the patients knew the indication of surgery but very few were informed about the possible complications and risk of the surgery and anesthesia

Pap smear, an important screening tool to detect precancerous stage of carcinoma of cervix

Many women can be saved from carcinoma of cervix by detecting and treating its precancerous stage. Pap smear is cheap and easily available in majority of institutes. The objective of this study is to determine the frequency of abnormal Pap smear and role of Pap smear in detecting precancerous stage of cancer cervix in women. This is retrospective descriptive study was conducted in gynaecology outpatient department of Isra University Hospital, Hyderabad, Sind from Nov 2006 to Oct 2009. All women who presented in OPD with gynaecological complaints were included in the study. Pregnant women were excluded from the study. Smear was collected with an Aryes spatula and relevant information was obtained from the patient's record and recorded on pre-designed Performa. Slides were then sent to pathology department. Data were analysed through SPSS-15 and presented as frequency and percentage. Total 981 women underwent Pap smear screening. Majority [63.3%] of the patients belonged to age group of 31-40 years. One hundred and eighty [18.34%] smears were normal and 792 [80.7%] were abnormal. Among these abnormal smears, 739 [75.33%] smears were inflammatory while 4 [0.40%] women had Ca in situ and 4 [0.40%] had squamous cell carcinoma. Pap smear is an important screening tool to detect precancerous stage of carcinoma of cervix. It should be done periodically in all married and high risk women for early detection of a precancerous stage

Maternal factors associated with low birth weight babies

To determine the maternal factors associated with low birth weight babies in women age of 15-35 years. Case control study. This study was carried out in the department of gynecology and obstetrics, Isra University Hospital [IUH] Hyderabad, Sindh from 02-05-2009 to 02-11-2009. Total 200 women were included in the study.100 as cases and 100 as control. Mothers aged 15-35 years, who deliver live or dead singleton baby through vaginal delivery or cesarean section after 37 week of gestation were included in the study while others who have delivered newborn with congenital abnormalities, had multiple pregnancy or known chronic illness [hypertension, tuberculosis, diabetes mellitus] were excluded from the study. The mean +/- SD of maternal age [years] in cases was26.40 +/- 4.77 and controls was 26.23 +/- 4.36 with P-value 0.739. The mean +/- SD of maternal weight [Kg] in cases was 53.13 +/- 8.93 and in controls was 64.97 +/- 13.72 with P-value < 0.001. Maternal history of smoking and anemia had significant association with low birth weight with P-Value of 0.005 and <0.001 respectively. It was concluded from our study that malnutrition, anemia, short stature like under weight and height are important risk factors for low birth weight

Frequency and severity of primary versus secondary dysmenorrhoea in women attending isra university hospital

OBJECTIVE: To find out the frequency and severity of primary versus secondary dysmenorrhoea

METHODS: This cross sectional prospective study was conducted at Isra University and Isra University Hospital, Hyderabad. From 1 March 2009 to 31 August 2009. A sample of 500 non pregnant women of reproductive age [15-49 years] currently menstruating, healthy with regular menstrual cycle including women visiting Gynaecology out patient department at Isra University Hospital and Female students of Isra University were included, while women with medical disorder such as thyroid disease, irregular menstrual cycle and psychiatric disorders were excluded. Data was collected by interview and filling of questionnaire after taking verbal informed consent

All results were analyzed on statistical software SPSS version 11. Frequencies and percentages were calculated, chi square test was applied among the categorical variables. P-value of less than or equal to 0.05 was considered as significant

RESULTS: This study included 500 women of reproductive age. There mean age was 26.830 + 6.32 ranging from 15 to 41 years. Out of 500 women 60 [12%] did not experience dysmenorrhoea, while dysmenorrhoea barely inhibits activities in 256[51.2%] and it alters lifestyle in 184 [36.8%]. Of these 331[66.2%] had primary dysmenorrhoea and 109 [21.8%] had secondary dysmenorrhoea with p-value 0.01

CONCLUSION: It is concluded from this study that dysmenorrhoea especially primary is a very common problem in our young girls

Use of misoprostol for induction of labour in unfavourable cervix

Objective of this study was to determine the maternal and fetal outcome after induction of labour with misoprostol in term pregnancies with unripened cervix. Experimental study. Non probability convenient, in the labour ward of Nawabshah medical college hospital Sindh, Pakistan from 6th April 2008 to 5th Dec 2008. Total 114 patients were induced with misoprostol who had singleton pregnancy of more than 36 weeks with cephalic presentation, reactive CTG and unfavorable cervix [Bishop Score <4]. Sampling strategy was non probability convenient sampling. However, patients with previous cesarean section, parity >4, nonreactive CTG, any contraindication to induction of labour and bishop score > 4 were excluded from the study. After taking an informed consent, patients were given 100mcg misoprostol in posterior fornix of vagina every 6 hour till 3 doses or initiation of labour. Labour was recorded on partogram. Maternal and fetal outcome were recorded on a self designed proforma. Majority of patients i.e. 63 [55.26%] belonged to age group of 23-30 years. Eighty seven [76.31%] patients who received induction were primigravida while 27 [23.68%] patients were P2-P4. Thirty six [31.57%] patients required single dose of misoprostol, 54 [47.36%] patients required two doses while 24 [21%] patients required three doses. Out of all these 114 patients, labour was successfully completed in 93 [81.57%] patients. While cesarean section was done in 21 [18.42%] patients. About 48 [42.10%] patients were delivered in 8 to 9 hours. Uterine hyper stimulation was seen in 9 [7.89%] patients. Apgar score was less than 7 in six [5.26%] newborns. Misoprostol is safe for induction of labour with an unfavorable cervix. The results were satisfying with minimal complications

Impact of maternal anemia on perinatal outcome

To evaluate the effect of maternal anemia on perinatal outcome. Cohort study Department of Obstetrics and Gynecology, Liaquat University Hospital Sindh Pakistan from March 2007 to December 2007. A total number of 1012 women were delivered during the study period. All singleton pregnant women who attended the out patient department before 18 weeks of gestation were included while women with multiple pregnancies, past history of preterm delivery and medical illness except anemia were excluded from the study. Relative risk and a 95% confidence interval were calculated through. Demographic and socioeconomic features of both groups were compared by Chi-Squared test using SPSS 17. A p-value of or less than 0.05 was considered as significant. A total of 818 women fulfilled the inclusion criteria, 407 in anemia group and 411 in non-anemic group. Hemoglobin range of anemic group was from 5 to 10 gram/dl. While in non anemic group hemoglobin ranges from 11 to 13gram/dl [mean11.87 +/- 0.54]. Risk of premature birth and low birth weight among anemic women was 3.92 and 2.2 times more than nonanemic women, which was statistically significant. Risk of IUGR was 2.2 times greater in anemia than non-anemic group. However this was statistically significant. Our study shows that risk of preterm delivery and low birth weight were greater in anemic group than non anemic group, which was statistically significant. Preconceptional evaluation along with planned pregnancy is important in decreasing the frequency of maternal anemia and its effect on fetus and newborn

Frequency and impact of premenstrual syndrome on quality of life

This study was conducted to determine the frequency and impact of premenstrual syndrome [PMS] on quality of life in women of reproductive age [15-49 years], and to determine if frequency estimates varied with menstrual flow. This cross-sectional study was carried out on 500 women of reproductive age currently menstruating, non-pregnant including women attending gynaecology outpatient department and female students of Isra University Hyderabad, from 1 -July-09 to 31 -December-09. Demographic data, and premenstrual Symptoms were recorded through interview and filling of predesigned questionnaire after taking verbal informed consent, and later analyzed on SPSS 11 for descriptive statistics and comparison of proportions using chi-squire test of Independence. This study shows very high frequency 81.25% of Premenstrual syndrome among women of reproductive age. The most frequent symptoms were reported Backache 446[89.2%] and fatigue in 446[89.2%] out of 500 women. Significant difference of weight gain, lower work or college performance, cramps, skin disorders, fatigue, mood swings, depression and tension were found in premenstrual and menstrual phases among study participants. Premenstrual syndrome is a common problem, have an adverse impact on a woman's quality of life and productivity

Factors for inaccessibility of antenatal care by women in Sindh

Antenatal care is important for pregnant women. By good antenatal care many complications of pregnancy can be prevented and lives can be saved. This study was carried out to find out the reasons of not utilising antenatal care, knowledge about dangerous signs and symptoms of pregnancy, and diet in women receiving and not receiving antenatal care. This descriptive study was conducted at Department of Obstetrics and Gynaecology, Liaquat University Hospital, Hyderabad Pakistan from February 2007 to October 2007. A total of 134 women who came for delivery were included in the study. Out of these, 71 women had received antenatal care while 63 did not receive antenatal care. After taking informed consent, women were interviewed regarding demographic data, reason of not utilising antenatal care, knowledge about diet and dangerous signs and symptoms of pregnancy. Twenty-eight [44.44%] women did not receive antenatal care because the facility was far away from home, 10 [15.87%] said that transport was not available. Tetanus toxoid coverage was higher among women who received antenatal care [p<0.0001]. Women who received antenatal care were more aware of the dangerous signs and symptoms of pregnancy than women who did not receive antenatal care. Most common reason of not utilising antenatal care was that facility was far away from there home. Women who received antenatal care were not anaemic and had received tetnus toxoid vaccination. They knew more about diet and dangerous sign and symptoms of pregnancy than women who had not received antenatal care

Attitudes towards menstruation among young women

To determine knowledge and different attitudes towards menstruation among young women. A descriptive study was carried out at Isra University Hyderabad and villages around the Isra University Hospital, from 1st April 2005 to 31st March 2006. Five hundred women from villages around Isra University Hospital and students of Isra University Hyderabad were selected by non-probability sampling who were of menstruating age irrespective of their marital and literacy status. Women with menstrual irregularities or any other gynecological or psychological problem were excluded. All information was recorded on a questionnaire Performa and analyzed on SPSS version 15.0. Out of 500 participants, 438 [87.6%] regarded menstruation as a natural process; whereas, 62 [12.4%] perceived it as a disease and curse from God. Out of 500, 415 [83%] of the participants responded that the menstruation process is good for health; however, 85 [17%] felt this process not healthy for themselves. Ignorance, false perceptions and unsafe practices regarding menstruation are not uncommon among young women, hence the importance of health education particularly of women living in rural areas. Then they will be better prepared emotionally to experience menstruation and will have less negative reactions

Awareness of women regarding analgesia during Labour

Delivery pain is one of the most severe pains that women experience during their life so a change can affect all dimensions of pregnant women and her family life. Aim of this study was to assess the women's knowledge of pain relief during labour, and their beliefs, fears, and misconceptions regarding epidural analgesia. It was descriptive study conducted in Obstetric and Gynaecology OPD of Liaquat University of Medical and Health Sciences, Hyderabad from September 2007 to January 2008. Women were selected randomly. All pregnant females who had delivered previously were interviewed. Primigravida were excluded from study. Information was collected on self-made questionnaire after an informed consent. Information was collected on computer software programme of SPSS 11.frequencies and percentages were calculated to express the results. Total 131 women were included in this study. Out of these 65, [49.6%] had no education while 41 [31.2%] had primary education. Majority of women [82, 62.5%] had knowledge about injections while few [12, 9.1%] women had knowledge about epidural analgesia. Seventy-nine [60.3%] had chosen the injections as preferred method during next labour. Regarding attitude towards labour pains, 61 [46.5%] feels that labour pains as severe pain. Regarding epidural analgesia 4 [3%] women thought that epidural analgesia will lead to weakness of limbs and 3 [2.2%] women thought that it will cause permanent backache. There was poor general awareness of women about the role of epidural analgesia in labour leading to a low patient demand for such services. Most of the women had gained knowledge regarding pain relief from past experience or from friends and relatives

Laparoscopic evaluation of female infertility

Sub-fertility is inability to ensure child bearing when it is wanted. Prevalence of sub-fertility in industrialised countries has been quoted as 20%, and seems to be on the rise. Traditional way to assess the uterine cavity, tubal structure and tubal patency was hysterosalpingography but it has now been largely superseded by laparoscopy and hysteroscopy. The objective of this study was to highlight the role of laparoscopy in establishing diagnosis of female infertility. This descriptive study was conducted in Gynaecology Unit of Liaquat University of Medical Health Sciences, Hyderabad, Pakistan from 28[th] August 2000 to 1[st] July 2001. Total 200 sub-fertile patients attended the gynaecology OPD. Out of these 30 patients were selected for laparoscopy and dye test who were suspected cases of endometriosis, abnormal HSG and unexplained infertility. Those patients who had medical disorders and contraindication for laparoscopy were excluded from study. Detailed history of every patient was recorded on a proforma and physical examination was performed. Laparoscopy was scheduled in proliferative phase of menstrual cycle. Data were analysed using SPSS 11. Frequency and percentages were calculated to describe the results. Out of 200 sub-fertile patients total 30 patients were selected for laparoscopy. Twenty [66%] patients were in primary infertility group while 10 [33%] patients were in secondary infertility group. Eleven [55%] patients of primary infertility belong to age group of 18-25 years while 6[60%] patients of secondary infertility belong to age group of 26-33 years [TABLE 1]. Mean duration of sub fertility at time of presentation in primary infertility group was 1.95 years while in secondary infertility was 2.70 years [Table 2]. In primary infertility group main associated symptoms were dysmenorrhoeal in 8 [40%], irregular cycles 5 [25%], and dyspareunia in 4 [20%]. In secondary infertility group 3 [30%] patients had dysmenorrhoeal and dyspareunia while 2 [20%] had irregular cycles. The commonest cause observed in patients with primary infertility was endometriosis spots which accounted for 11 [55%]. In secondary infertility tubal occlusion was more common which accounted for 3 [30%]. Laparoscopic procedures are less invasive, more convenient and more precise for diagnosis of sub-fertility in women

Role of uterovaginal packing in postpartum hemorrhage

Objective: To find out the safety and efficacy of uterovaginal packing in postpartum hemorrhage in terms of complications and success to arrest bleeding

Place and Duration of Study: This study was conducted at Department of Obstetric and Gynecology Nawabshah Medical College Hospital, Sindh-Pakistan from 2[nd] January 2008 to 4[th] August 2009

Patients and Methods: In this prospective interventional study all patients presenting with postpartum hemorrhage who did not responded to medical treatment, placenta previa or coagulation failure, following vaginal delivery or cesarean section, were included. Multiparous women were also included in the study if they expressed strong desire to conserve uterus. Cases of ruptured uterus, perineal trauma, cervical trauma and vaginal trauma were excluded from this study. Frequencies and proportions of complications were calculated along with rate of successful cessation of bleeding. Data were analysed by SPSS version 11

Results: During study period 138 patients of postpartum hemorrhage underwent uterovaginal packing. Uterine atony unresponsive to oxytocics was the commonest cause of postpartum hemorrhages [n=88, 63.76%] followed by coagulopathy in 25 [18.11%]. Uterovaginal packing was successful in 89.14% patients. Post-insertion morbidity included fever more than 100[degree sign] F in 25 [18.11%] and episotomy wound infection in 9 [6.52%] patients

Conclusion: Results of this study show that uterovaginal packing is effective in arresting the bleeding. Uterovaginal packing still retains an important role in emergency obstetrics

Emergency obstetric hysterectomy frequency and maternal outcome

To review the frequency, indications and maternal outcome of emergency obstetric hysterectomy. Descriptive study. In obstetrics and gynecology department of Nawabshah Medical College Hospital Sindh from 2nd May 2005 to 31st April 2008. During the study period total 3089 patients were delivered. Out of these, 37 patients underwent cesarean hysterectomy. Records of all the patients were analyzed. The parameter analyzed were age, parity, social status, booking status, indication for operation, operative notes, maternal outcome, complications and postoperative status. Mortality register was also checked for the causes of maternal deaths. During the study period, there were 3089 deliveries. Amongst these 37 had emergency obstetric hysterectomies giving rise to a frequency of 11.9 / 1000 cases. Regarding parity, 23[62.1%] were multiparous, 12 [32.4%] patients were grand multiparous and 2 [5.4%] patients were primiparous. Commonest indication of emergency obstetric hysterectomy was postpartum hemorrhage due to uterine atony which was seen in 13[35.1%] cases, followed by ruptured uterus in 11[29.7%] cases, placenta previa in 6[16.2%] cases, and couveliar uterus in 5 [13.5%] cases and placenta accreta in 2 [5.4%] cases. Commonest maternal complications were urinary tract infection in 6[16.2%] patients followed by DIC in 5[13.5%] patients. Maternal mortality was seen in 2[5.4%] patients. In our study frequency of emergency obstetric hysterectomy was high. Most common indication was rupture uterus, post partum hemorrhage due to atony uterus and placental causes. After UTI, disseminated intravascular coagulation was most common complication seen. 2patients were expired. Sever Emergency obstetric hysterectomy when performed in selected cases at an appropriate time helps in bringing down maternal mortality

Asymptomatic bacteriuria in pregnancy

To determine the frequency and risk factors of asymptomatic bacteriuria during pregnancy. Descriptive study. In obstetric and gynecology outpatient department of Isra university hospital Hyderabad Sindh from 2 nd July to 10 th December 2007. Total 111 women were included in the study. Inclusion criteria were pregnant women with no clinical features suggestive of UTI. Symptomatic women, women with any medical or renal disease and those who had taken antibiotics in last 6 weeks were excluded from the study. Dipstick test was performed on MSU and urine was cultured incase of positive dipstick. Data was analyzed on SPSS version 11. Frequencies were runned and chi-square test was used as test of significance. A total of 111 women fulfilling the inclusion criteria were interviewed and tested for bateriuria. Out of them 10% [9%] had bacteriuria. Out of them 10% were below 20 years and 90% were between 20-30 years [p=0.17]. Regarding education 10% were literate and 90% were illiterate [p=<0.001]. Prevalence of bacteriuria was 100% in women who had past history of urinary tract infection [p=0.004]. 80% of women who were sexually active had bacteriuria while 20% had not [p=0.006]. No association of bacteriuria was found with anemia, age, parity and socioeconomic condition. Asymptomatic bacteriuria is a common infection during pregnancy, have strong association with education, past history of urinary tract infection and illiteracy

audit of cesarean sections in a teaching hospital

To determine the frequency of factors responsible for apparently high cesarean section rate in teaching hospital, Liaquat university hospital Hyderabad and to assess maternal morbidity and fetal out come after cesarean section. Descriptive study. In obstetric and gynecology Department of Liaquat university hospital Hyderabad Sindh Pakistan from 3 rd January 2007 to 2 nd January 2008. Total 1666 deliveries were conducted in year 2007 to 2008. Out of these 584 were delivered by cesarean section and 1082 were delivered by normal vaginal delivery. Clinical record of all the patients who underwent Cesarean section was analyzed. All the patients who underwent cesarean section were included in this study while clinically diagnosed cases of ruptured uterus and proved on lapratomy were excluded from this study. A proforma of each patient was completed, regarding the relevant information of cesarean delivery and fetal outcome. Cesarean section was done on 584 [35%] patients while normal vaginal delivery was conducted on 1082 [65%] patients. A total of 149 [25.5%] patients' underwent elective cesarean section while in 435 [74.4%] patient's cesarean section was done in emergency. A total of 144 [24.7%] patients were booked while 440 [75.3%] patient's were unbooked. Most common indication of cesarean section was repeat cesarean section, which was seen in 182 [31.2%] patients. Among obstetric complications major problem encountered was massive hemorrhage, which is seen in 64 [11%] patients wounds sepsis was second most common complications. A total of 453 [77.6%] newborns were born alive and 50 [8.6%] neonates were dead which included fresh and macerated still birth. 81 [13.8%] neonates died later on in pediatric unit [END]. The rate of cesarean section in our study was 35%, which is quite high. Commonest indication of cesarean section observed in this study was previous cesarean section. Majority of patient's who underwent cesarean section were unbooked. Commonest obstetric complication was massive hemorrhage followed by wound sepsis. Perinatal mortality was also high in this study

Frequency and indications of cesarean section in a tertiary care hospital

To determine the frequency of cesarean section and to analyze the indications, so as to introduce measures to control the cesarean section rate. This descriptive study was conducted in obstetric and gynecology department of Isra university hospital Hyderabad Sindh from 1st Jan 2007 to 31st Dce 2007.In this study clinical record of all the patients who underwent cesarean section was analyzed. It included all the pregnant ladies booked in the antenatal clinic and unbooked patients admitted in early labour for whom cesarean section was indicated later. It also included all those cases coming in emergency at any time for which cesarean section was indicated. Clinically diagnosed cases of ruptured uterus proved on laparotomy were not included in the study. Data was analyzed on SPSS version 11 and frequencies as wall as percentages were calculated. During one year study period, 380 cesarean section were performed. The rate of cesarean section was 64.7%. Emergency cesarean section was performed in 225 [59.2%] patients and elective cesarean section in 155 [40.7%]. Among 380 patients, 167 [43.9%] were booked while 213 [56.0%] were unbooked. Repeat cesarean section was the commonest indication seen in 73 [19.2%] patients followed by dystocia in 51 [13.4%] patients, fetal distress in 48 [12.6%] and ante partum hemorrhage in 45 [11.8%] patients. Miscellaneous indications contributed to 16 [4.2%] of the cases. Majority of patients who underwent cesarean section was unbooked and had an emergency cesarean section. The commonest indication was repeat cesarean section

Postpartum hemorrhage: an experience at tertiary care hospital

To determine the frequency, causes and various treatment methods used in for postpartum hemorrhage [PPH] our setup. Descriptive study. This study was conducted in the Department of Obstetrics and Gynecology Unit 1, Liaquat University of Medical and Health Sciences Hyderabad, from June 2007 to April 2008. All women admitted with or developed PPH in hospital after delivery or cesarean section were included. Patients with history of bleeding disorders and those on heparin/warfarin were excluded. Results were analyzed through computer software program SPSS version 11 and percentages were used to describe the data. Total number of obstetric admissions during the study period was 1231. Out of these 118 [9.5%] patients developed PPH. Out of these 118 patients, 98[83%] patients had primary PPH while 20[16.9%] patients had secondary PPH. Seventy five [63.5%] patients were unbooked while 43[36.4%] were booked. Regarding causes of PPH, most common cause was uterine atony in 76[64.4%] cases, followed by perineal and vaginal tears in 41[34.7%] patients and prolonged labor in 29[24.5%]. Uterine massage was done in 76[64.4%] patients, B-Lynch sutures were applied in 6[5%] cases and hysterectomy done in 4[3.3%] patients. Majority of patients developed primary PPH and the commonest cause was uterine atony. PPH was commonly seen in unbooked patients, induced/ augmented labor and grand multiparous women

Hepatitis C: frequency, risk factors and pregnancy outcome

To determine the frequency of HCV in pregnant women, to find out the risk factors for HCV in pregnant women and to compare the pregnancy outcome of HCV positive with HCV negative mother. Case - control study. Obstetrics and Gynecology Department of Isra University Hospital Hyderabad, from Nov 2007 to August 2008. Study was conducted on pregnant women who were screened for HCV antibody during antenatal consultation and were admitted for delivery. Five ml blood was drawn from each patient and serum was tested for anil HCV by ELIZA. Detailed history was taken for evaluation of risk factors. All results were analyzed on statistical software SPSS version 16. Fishers exact test or Chi square were applied among the categorical variables. Frequencies and percentages and 95% confidence intervals were calculated. Student t test was also used to compare the mean [2 tailed] of numerical parameters. P value of less than or equal to 0.05 was considered as significant. Frequency of hepatitis C in our study was 8% [n-23]. After computing the measures of association for cases and controls with regard to the risk factors, history of previous surgery [p=0.01], blood transfusion [p=0.02], dental surgery [p=0.004] and history of injections [p=0.01] were found to have significant association with HCV positive status of the patients. Logistic regression was used to control the effects of various risk factors under study and to find out the direct effect of risk factors on HCV positive status. Using logistic regression, history of previous surgery [p=0.01], blood transfusion [p=0.02], dental surgery [p=0.04] and history of injections [p= <0.001] were found to have significant association with HCV positively in our study. Statistically no significant difference was found in birth weight, gestational age and Apgar score of new bom in cases and control groups. Frequency of hepatitis C in our study was 8%. No adverse effect on pregnancy outcome was observed when compared to controls

Eclampsia; frequency and morbidity

The purpose of our study was to find the outcome, frequency, maternal morbidity and perinatal outcome due to eclampsia in our set up. Descriptive study. This study was conducted in the department of obstetrics and gynae from 1st January 2007 to 1st January 2008 in Gynecology and obstetric department: unit 1 of Liaquat University hospital Hyderabad. Total 39 patients who had eclampsia were included in this study while other obstetric patients who had no eclampsia were excluded from the study After an informed consent information was recorded on predesigned proforma regarding maternal age, parity, duration of pregnancy, B.P at admission mode of delivery maternal morbidity and perinatal outcome. Results were analyzed through computer software programme SPSS version 11 and percentages were used to describe the data. Total 1415 deliveries were conducted during the study period. Out of these 39 patients had eclampsia. So the frequency of eclampsia was 2.7% Majority of patients i.e. 15 [38.4%] were less than 20 years. Out of 39 patients 32 [82.0%] patients were primigravida while 4 [10.2%] were multigravida and 3 [7.6%] patients were grandmultigravida. Majority of the patients i.e. 28 [71.7%] were unbooked. 18 [46.1%] patients had fit during antenatal period 14 [35.8%] patients had fit in postpartum period one case with eclampsia was received on 6th postnatal day. Serious maternal morbidity was pulmonary edema seen in 6 [15.3%] HELLP Syndrome in 3 [7.6%] and acute renal failure in 4 [10.2%] patients. Regarding perinatal outcome 28 [71.7%] babies were born alive out of these 11 [39.2%] were died in early neonatal period 8 [20.5%] babies born, were still birth while 3 [7.6%] were macerated IUD. In our study majority of patients who developed eclampsia were young and primigravida Major maternal morbidity was pulmonary edema chest infection and acute renal failure. Perinatal mortality was also high

Laparoscopic evaluation of chronic pelvic pain: experience at a public sector university hospital

To evaluate laparoscopically the causes of chronic pelvic pain in our set-up, so that appropriate treatment could be offered to these patients and unnecessary hospital visits and repeated use of antibiotics are avoided. A descriptive study. Obstetrics and gynecology outpatient department [OPD] of Liaquat University Hospital Hyderabad, Sindh - Pakistan from 1[st] October 2006 to 31[st] March 2007. This study was based on sample of convenience and conducted on women who attended OPD. A total of 4301 patients attended the OPD. Among them, 271 patients attended the OPD because of chronic pelvic pain. They were thoroughly interviewed and investigated. Those patients who did not respond to symptomatic treatment were advised laparoscopy. Thirty-three patients who fulfilled the inclusion criteria and gave consent were selected for laparoscopy. Informed consent was taken and detailed history, thorough examination and necessary investigations were carried out. Patients with serious heart or lung disease, peritonitis, intestinal obstruction, abdominal operations and malignancy were excluded. Diagnostic laparoscopy was carried out under general anesthesia and operative findings were noted on a proforma. Data were analyzed through software programme SPSS version 11.0. Of these 33 patients, majority 17[51.52%] belonged to 31-41 years of age group and were multiparous patients [57.58%]. Seventeen [51.52%] patients had dull, deep pelvic pain with occasional sharp episodes. Only 03[9.1%] patients with acute pain required hospitalization. Eleven [33.33%] patients complained of subfertility, 7[21.21%] had dysmenorrhea while 05[15.15%] had dysfunctional bleeding. Only 04[12.12%] patients complained of backache low down in the lumbosacral region. No any sign was present in 7[21.21%] patients. Uterus was bulky in 11[33.33%]patients. Adnexal masses were felt in 06[18.18%] patients while 05[15.15%] had nodularity in pouch of Douglas. Regarding laparoscopic findings, 11[33.33%] patients had chronic pelvic inflammatory disease. Varying degree of endometriosis was seen in 09[27.27%] patients. In 04[12.12%] patients, no abnormality was detected. This study emphasizes the importance of laparoscopy in evaluating the cause of chronic pelvic pain. This procedure shall be considered an essential investigation in the management of such patients so that repeated and unnecessary use of antibiotics and other drugs could be avoided