Comparison of active and conservative management of post-term pregnancy: a quasi- experimental study

Objective: To compare the maternal and perinatal outcomes of prolonged pregnancy between active and conservative group

Study Design: Quasi experimental study

Place and Duration of Study: This study was conducted at the Department of Obstetrics / Gynaecology Unit-1, Mother and Child Health Centre, Pakistan Institute of Medical Sciences, Islamabad from March 2003 to Feb. 2004

Materials and Methods: There were one hundred cases, fifty in each group with a technique of convenient sampling. Women with uncomplicated pregnancies at >/=41 weeks and

Results: Comparison of both groups management showed that mean duration of labour in active group was prolonged than that of conservative group [p =0.001]. Interventional deliveries rate was high in active group than conservative group with p value significant statistically. Comparison of intra-partum fetal distress, neonatal morbidity including 1 minute, 5 minute Apgar score and admissions to NICU in both groups was not statistically significant. There was no perinatal mortality in both groups

Conclusion: Active management of prolonged pregnancy increases the maternal morbidity without improving perinatal outcome

Effect of passive smoking on the levels of pregnancy associated plasma protein -a in normal rats

To measure the levels of pregnancy associated plasma protein- A [PAPPA-A] in normal rats exposed to cigarette smoke. Experimental interventional study. Army Medical College, Rawalpindi, in collaboration with national institute of health [NIH], Islamabad. Total duration was of 4 weeks. Sixty albino rats of Sprague- Dawley strain weighing 200-250 gm, divided into two groups. Both the groups were kept in identical chambers. One group of 30 rats was further exposed to passive cigarette smoke for 4 weeks. No increase was observed in the levels of serum PAPP-A of both the groups: Passive smokers and not exposed to passive smoking i.e. P > 0.05. Smoking does not increase the levels of PAPP-A

Transurethral electrovaporization vs transuretheral resection of prostate for the management of benign prostatic hyperplasia: a comparative study at pims, Islamabad, Pakistan

To compare and determine the safety and efficacy of transurethral electrovaporization of prostate [TUVP] over transurethral resection of prostate [TUR.P] for management of benign prostatic hyperplasia [BPH]. This comparative randomized clinical study was carried out in Pakistan Institute of Medical Sciences [PIMS] Islamabad, Pakistan from May 1997 to April 1998. One hundred patients with signs and symptoms of benign prostatic hyperplasia were selected from Urology out patient department of Pakistan Institute of Medical Sciences [PIMS] Islamabad, Pakistan. They were divided into two groups of fifty each; one group underwent TURP and other TUVP. Post operative follow ups to assess the results of both the procedures were carried out at 2, 12 and 24 weeks. For approximately the same size of prostate, the mean operation time [39.7 mins] was longer for TURP as compared to TUVP [25.22 mins]. The hemorrhage was more with TURP. Clot retention incidences were five in TURP as compared to none in TUVP. The mean volume of irrigation fluid used during operation [7.5 liters] was far less in TUVP as compared with what was required in TURP [12.0 liters]. The changes in sodium and hematocrit were monitored by taking pre and post operative blood samples. The variations in the levels before and after TUVP were negligible, while TURP group patients were noted to have post operative hyponatremia. The maximum post operative stay was 3 days in TUVP [mean 2 days] compared to 7 days in TURP [mean 6 days]. As far as post operative complications were concerned, infection and perforation incidences were more in TURF compared to TUVP. Although TURP is much effective gold standard for treating BPH, it is a bit costly with higher morbidity and complication rate as compared to TUVP which is a minimal invasive technique suitable for smaller sized prostate in high surgical risk patients

Association of c-reactive protein as an inflammatory marker with the glycaemic status of the alloxan treated diabetic rats

To measure the level of C-reactive protein and find its association with the glycaemic status [fasting plasma glucose, glycosylated haemoglobin] of metabolically normal and diabetic albino rats. Total 60 Albino rats were included into [metabolically normal rats n=30; diabetic rats n =30]. Plasma glucose levels were determined by using glucose oxidase method while determination of total Hb and glycosylated hemoglobin [HbA[1]c] was done by diagnostic kit that uses weak cation-exchange resin to bind Hb. The% HbA[1]c was determined by measuring the absorbance at 415 nm of the glycosylated hemoglobin fraction and the total hemoglobin fraction. The ratio of the two absorbances gave the% of HbA[1]c. C-reactive protein was measured by the ELISA kit. Significant difference was found in the values of fasting glucose, of the normal and diabetic groups [p<0.05] but no significant difference was present in the values of HbA[1]c of both groups. There was no significant difference in the values of C-reactive protein of the normal and diabetic groups. Short duration hyperglycemia has no role in producing inflammation and raising the levels of bioinflammatory marker C-reactive protein

Effect of thiamine on lipid profile in diabetic rats

To determine the effect of high dose thiamine on dyslipidemia in diabetic rats. Experimental interventional study. The Animal House/Laboratory of the National Reference Laboratory for Poultry Diseases [NRLPD]/Biochemistry Department, Army Medical College, Rawalpindi, from December 2006 to January 2007. The study was conducted on 120, 12 weeks old male albino rats of Sprague Dawley Strains randomly divided into 4 groups of 30 rats each. Group I comprised of 30 normal rats, on normal [regular] diet. Group II comprised of 30 diabetic rats, on normal [regular] diet. Group III comprised of 30 normal rats, on thiamine supplemented diet. Group IV comprised of 30 diabetic rats, on thiamine supplemented diet. Out of the 120 rats, 60 were made diabetic by injecting Alloxan. Blood glucose levels were measured by applying glucose oxidase method. Determination of total HbA1c, triglyceride, HDL [High Density Lipoproteins] and total cholesterol was performed by diagnostic kits. The significance of difference in mean values of study groups [glycemia and lipid profile] was assessed by applying ANOVA and independent Student's t-test. Significant difference was found in the levels of triglycerides, cholesterol and LDL in the diabetic rats on supplemented diet p < 0.05, but no significant difference was noticed in the value of glycosylated Hb [HbA1c] [p > 0.05] of all the 4 groups. Thiamine corrected dyslipidemia but not hyperglycemia in diabetic rats