Awareness and practices regarding sexually transmitted infections among currently married males and females in a rural district of Sindh

To determine the levels of awareness and practices regarding sexually transmitted infections [STIs] in a Rural District of Sindh - Pakistan. It was a cross - sectional survey conducted in Taluka Khipro, District Sanghar-Sindh during June 2004 in fifteen villages. Data was collected through a structured questionnaire by trained local male and female workers who interviewed door to door. A total of 116 currently married males and females were interviewed. Majority of males 34[29%] were in 25-29 years age group, while among females 32 [28%] fell in 20-24 years age group. Majority of males i.e. 79 [68%] and females 108[93%] was not educated. Only 36[31%] males or females knew symptoms of STIs like vaginal discharge, discharge from urethra and back pain. Twenty-five [22%] males and 12[10%] females reported that "only wife can have sexual disease". Two [2%] females shared that both [male and female] can have Sexually Transmitted Infections [STIs], AIDS and Hepatitis C. Male respondents [72%] knew different symptoms of STIs. Majority of males [78%] and females [51%] were aware about Hepatitis B and C infections. Majority of respondents had never heard about AIDS. Only 4% males were of the view that it spreads by inappropriate sexual relation. Sixty married females [52%] had knowledge about any contraceptive method. No subject [male or female] reported having ever used any contraceptive method. This study depicts poor picture of a rural population in awareness and practices regarding STIs in particular and reproductive health in general in the target area. This was a limited study and to further explore reproductive health issues in rural areas, studies with larger sample size and stronger statistical evidence are required

Frequency of second stage intervention and its outcome in relation with instrumental vaginal delivery versus caesarean section

To determine the frequency of second stage intervention and the risk of maternal and foetal morbidity and mortality associated with instrumental vaginal deliveries versus caesarean section in our tertiary care set up. This descriptive study was conducted in the Department of Obstetrics and Gynaecology [Unit-II] Liaquat University Hospital Hyderabad Sindh, Pakistan from January 2005 to December 2006. All the women who underwent instrumental vaginal delivery and caesarean section due to prolonged second stage of labour were included in this study. Data were collected on a pre-designed proforma, which included demographic details, maternal and perinatal morbidity as well as any complications etc. Finally, data were analysed through software program SPSS 10.0. Frequency of second stage intervention was 22.2%. Among, 400 women who undergone second stage intervention, 240 [60%] were delivered by caesarean section and 160 [40%] were delivered with the help of instruments. Majority of women, i.e., 49.25% were between 21-30 years of age, 73% were un-booked cases while 45% cases were primigravida. Complications with abdominal delivery were paralytic ileus in 35 [14.58%] cases, post partum haemorrhage in 30 [12.5%] cases and tear extension in 13 cases. Complications with instrumental delivery were vaginal tear in 28 [17.5%] cases, cervical tear in 12 [7.5%] and third degree perineal tear in 4 [2.5%] cases. The perinatal outcome with abdominal delivery [86.66%] was better as compared to instrumental delivery [72.5%]. The frequency of second stage intervention seems high in our set up and is associated with significant maternal and perinatal morbidity. Maternal morbidity was more frequent abdominal delivery while neonatal morbidity and mortality was more frequent with instrumental delivery

Clinical spectrum and management of ovarian tumours in young girls upto 20 years of age

Ovarian tumours are one of the common malignancies all over the world affecting all age groups. This study analyses different clinical presentation and management of ovarian tumours in young girls up to 20 years. Patients up to 20 years of age admitted with the diagnosis of ovarian tumour were included. Data collected on a proforma. Variables studied included age, presenting symptoms, investigations, surgical findings, type of surgery, histopathology reports and follow-up. The patients with malignant ovarian tumour were followed by oncologist as well as gynaecologist. Data analysis was done on SPSS. The mean age was 17.27 +/- 2.46 SD years. The common symptoms included abdominal mass, abdominal pain, urinary problems, menstrual irregularities and generalized malaise. All patients were operated after preliminary investigations. Patients were advised to have follow-up post-operatively after 1 month. The follow up was done by oncologist and gynaecologist. Six patients [12.5%] died and 22 [45.83%] were lost to follow up. Ovarian tumours are quite common in young girls. Majority of patients seek medical advice once the disease becomes symptomatic, complicated or advanced disease in the case of malignancy. Histopathology of the tumours revealed that epithelial cell tumour is the commonest tumour in contrast to germ cell tumour as reported by world literature

Pattern of fetal deaths at a university hospital of Sindh

Perinatal mortality is a significant public health problem throughout the world. Its prevalence is quite high in the developing countries on account of number of factors. Most of the causes are treatable and fetal outcome can be improved by provision of good health care facilities during antepartum and intrapartum periods and through public education regarding reproductive health and better utilization of health services. To determine the pattern of intrauterine fetal deaths before or in the process of labor in our tertiary care set up. This descriptive case series was conducted at Department of Obstetrics and Gynaecology [unit-IV] at Liaquat University Hospital, Jamshoro, Sindh, from April 2002 to October 2003. In total, 50 intrauterine fetal deaths from 24 weeks of gestation to full term pregnancy were analyzed. The case records of all the women were evaluated and data collected regarding their age, period of gestation, clinical features, antenatal records, previous obstetrical history, labor, mode of delivery as well as complications during or after the labor. Out of 697 deliveries, 50 [7.17%] babies were still born. Of these 84% were fresh still born. The commonest factors were antepartum hemorrhage [30%], mismanaged labor [26%], premature rupture of membranes [26%] and congenital anomalies [16%]. Majority of fetal deaths in our set up are due to avoidable factors. Hence, there is strong need to improve the quality of care by proper antenatal care, identification of high risk cases and referral to tertiary care hospitals for proper management to prevent morbidity and mortality in this regard

Tuberculosis control in pakistan: Current issues and challenges

Tuberculosis [TB] is a contagious disease, which spreads as a droplet infection. It is the leading killer of young adults worldwide. Each year, 8 million people develop active TB and 3 million die. The largest number of cases occurs in the South-East Asia Region, which accounts for 33% of incident cases globally. However, the estimated incidence per capita in Sub-Saharan Africa is nearly twice that of the South-East Asia, at 350 cases per 100,000 population. Overall, one-third of the world's population is currently infected with the TB bacillus and someone is newly infected with TB bacilli every second. HIV and TB form an even more lethal combination; TB is also a leading cause of death among HIV-positive people and accounts for about 13% of AIDS deaths worldwide. However, in Africa, HIV is the single most important factor determining the increased incidence of TB in the past 10 years. This is an Editorial

Meigs' syndrome

Meigs syndrome is a rare clinical condition commonly considered to be associated with malignant ovarian tumour. A case of unmarried female is presented who came with a slowly increasing abdominal mass. Clinical and ultrasonic investigations revealed a mobile, solid right adenexal tumour in the lower abdomen, along with ascites and pleural effusion of the right lung. The level of CA 125 was also raised. Diagnosis of Meigs syndrome was confirmed after surgical intervention. The tumour was successfully removed and pleural effusion disappeared 15 days after the intervention. Cytomorphologic study of both the tumour and ascitic fluid was negative for malignancy

Therapeutic effects of honey versus silver sulphadiazine in the management of burn injuries

To determine the therapeutic effects of honey versus silver sulphadiazine 1% in the management of burn injuries, in our set up. A quasi-experimental study. Burns emergency unit, department of Plastic Surgery Liaquat University Hospital, Hyderabad - Sindh form January 2002 to December 2003. Eighty patients having age range of 4 to 62 years with burn involving 10% to 40% body surface area were studied. Patients presenting with chemical or electric burn, and those with full thickness burn were excluded. Majority of cases was males. Patients were divided in two groups. One group received treatment with honey while other received silver sulphadiazine. Honey used was natural and unprocessed. Patients treated with honey showed rapid wound healing with no apparent local or systemic side effects. Mean duration of healing in honey treated group was 15.3 days. While in other group, mean was 20 days. Patients treated with honey did not develop growth of any pathogenic organism. However, 32[80%] patients treated with silver sulphadiazine showed growth of different pathogenic organisms necessitating the use of systemic antibiotic therapy accordingly. In honey group, only 3[7.5%] patients developed contracture as compared to 7[17.5%] patients treated with silver sulphadiazine. After complete healing, itching/pruritus was complained by 13[32.5%] patients treated with silver sulphadiazine while only 2[5%] patients complained so treated with honey. The burn wounds are healed rapidly by using honey with minimum scarring and pigmentation as compared to silver sulphadiazine. Use of honey in these patients can be cost effective in terms of treatment and hospital stay. However, to develop more confidence with the use of honey in burn wound management, more studies with larger sample size are needed