study of post-caesarean section wound infections in a regional referral hospital, Oman

The aim of this study was to determine the incidence of surgical site infections [SSI] in patients undergoing a Caesarean section [CS] and to identify risk factors, common bacterial pathogens and antibiotic sensitivity. SSI significantly affect the patients quality of life by increasing morbidity and extending hospital stays. A retrospective cross-sectional study was conducted in Nizwa Hospital, Oman, to determine the incidence of post-Caesarean [PCS] SSI from 2001 to 2012. This was followed by a case-control study of 211 PCS cases with SSL Controls [220] were randomly selected cases, at the same hospital in the same time period, who had undergone CS without any SSL Data was collected on CS type, risk factors, demographic profile, type of organism, drug sensitivity and date of infection. The total number of PCS wound infections was 211 [2.66%]. There was a four-fold higher incidence of premature rupture of the membranes [37, 17.53%] and a three-fold higher incidence of diabetes [32, 15.16%] in the PCS cases compared with controls. The most common organisms responsible for SSI were Staphylococcus aureus [66, 31.27%] and the Gram-negative Escherichia coli group [40, 18.95%]. The most sensitive antibiotics were aminoglycoside and cephalosporin. Polymicrobial infections were noted in 42 [19.90%], while 47 [22.27%] yielded no growth. A high incidence of associated risk factors like obesity, hypertension, anaemia and wound haematoma was noted. Measures are recommended to reduce the incidence of SSI, including the implementation of infection prevention practices and the administration of antibiotic prophylaxis with rigorous surgical techniques

Uterus didelphys with obstructed right hemivagina, ipsilateral renal agenesis and right pyocolpos: a case report

Uterus didelphys with obstructed hemivagina and ipsilateral renal agenesis [OHVIRA Syndrome] is a rare congenital anomaly of the female genital tract. Uterus didelphys occurs when the midline fusion of the mullerian ducts is arrested, either completely or incompletely. Women with didelphic uterus may be asymptomatic and unaware of having a double uterus. They may present with complaints of dysmenorrhoea and dyspareunia. A 25 year old woman attending the infertility clinic at Nizwa regional referral hospital presented with history of dysmenorrhoea and foul vaginal discharge with right cystic pelvic mass. She was diagnosed as a case of double uterus with obstructed right hemivagina and right pyocolpos with ipsilateral renal agenesis after routine ultrasonography in the clinic followed by MRI. Excision of the right vaginal septum with drainage of 200 ml of purulent discharge was performed. She was relieved of her symptoms and conceived promptly after the surgical excision of the partial vaginal septum

Methotrexate treatment of ectopic pregnancy: experience at Nizwa hospital with literature review

Ectopic pregnancy occurs when the embryo fails to implant within the uterine cavity. Methotrexate, a folic acid antagonist has been widely used to treat ectopic pregnancy. The aim of this study is to determine the efficacy of methotrexate treatment for ectopic pregnancies in our settings which will in-turn help us reduce maternal mortality and morbidity. This was a retrospective review of 60 cases of ectopic pregnancy treated with single dose methotrexate in Nizwa hospital, Oman. Demographic data, clinical presentation, treatment progress, outcome, side effects and future fertility follow up were analysed using a computer database. Selection criteria included hemodynamically stable women with beta-hcg level of

Rupture of non-communicating rudimentary uterine horn pregnancy

Unicornuate uterus with rudimentary horn is a rare type of uterine malformation associated with obstetrical complications. Rupture of pregnant rudimentary horn is the usual presentation resulting in severe haemoperitoneum with increased maternal morbidity, and at times, mortality. A case of ruptured rudimentary horn pregnancy in a 24-year-old, second gravida, is reported. Exploratory laparotomy revealed a ruptured rudimentary horn pregnancy of 14 weeks gestation with haemoperitoneum. Excision of the rudimentary horn was done and an uneventful recovery followed