National study of reproductive tract infections among high risk groups of Lahore and Karachi

To estimate the prevalence of reproductive tract infections [RTIs] among the Female Sex Workers [FSWs], Male Sex Workers [MSWs], Injecting Drug Users [IDUs] and truck drivers. Cross-sectional. Lahore and Karachi, from March to August, 2004. Four hundred FSWs, 400 MSWs, 200 eunuchs, 400 IDUs and 400 truck drivers were interviewed and examined. Biological testing included PCR and ELISA. The mean prevalence of syphilis was 17.7% [95% CI: 15.1-20.3%]. Genital gonorrhoea was found among 0.8-12.3% of subjects with mean of 4.5% [95% CI: 0.8-5.2%]. Genital chlamydia was seen in 0.2-11% individuals with mean of 2.6% [95% CI: 2.1-3.1%]. Trichomonas was present in 19.3% FSWs of Lahore and 5.52% FSWs of Karachi. Only 0.8% truckers in Lahore had trichomonas. In Lahore, 47.6% FSWs and in Karachi, 27.4% FSWs were positive for bacterial vaginosis. A vast majority of IDUs, 91.8% in Lahore and 87% in Karachi were hepatitis C positive. The prevalence of syphilis is very high among all high-risk groups; particularly so among eunuchs [60.2% in Karachi and 32.3% in Lahore]. Such a high levels of RTIs indicate a serious threat for HIV epidemic because of socially transmitted infection

Effect of maternal anemia on placental ratio

To determine the effect of maternal anemia on placental ratio. Cohort study. Unit-1, Department of Gynaecology and Obstetrics 1, Sir Ganga Ram Hospital, Lahore from August 2002 to August 2003. One hundred pregnant women, 50 anemic and 50 having normal range of Hb were included in the study. After delivery, weight of the new born and weight of placenta was recorded. The fetoplacental ratio was calculated for both groups and compared. The mean weight of the newborn [+/-SD] in anemic group was 3.12 +/- 0.45 kg and 3.18 +/- 0.35 Kg in control group. The difference was statistically non-significant [P=0.445]. The mean placental weight of anemic groups was 0.58 /- 0.13 Kg and that of control group was 0.52 +/- 0.088 Kg showing a significant increase [P<0.009]. Feto-placental ratio was 0.193 +/- 0.035 [Mean +/- SD] in anemic patients and 0.166 +/- 0.024 in control group. FP ratio of anemic patients was significantly higher than control group [P<0.001]. This study confirms that anemia during pregnancy is associated with significantly large placental weight and a high fetoplacental ratio

Profile of men suffering from sexually transmitted infections in Pakistan

To evolve effective prevention and efficient treatment strategies for sexually transmitted infections [STIs] in a country, comprehensive understanding of the prevalent STI and their modes of transmission is needed. The aim of this present study was to generate such data for Pakistan. Method: The study was conducted between June 1999 and September 1999 in four provincial capitals. In each city, data were collected from one or more teaching hospitals and a number of general practitioners. During this period, 465 men suffering from STIs were interviewed. The mean age of study population was 31.9 +/- 8.6 years, 60% were married, 58.3% urbanites, 81.7% living with their families and 83.3% smokers. Only 10.5% were drug addicts. Out of 465 cases, 27.5% cases had gonorrhoea, 31.6% syphilis, 17.2% chancroid, 18.3% herpes, 5.2% chlamydial infections while only one case [0.2%] was HIV positive. Most men [55%] acquired the infection heterosexually, 11.6% through homosexuality, 18.4% through bisexual relations and 2 men [0.5%] reported bestiality. Among 78.1% of those contracting the infection heterosexually, the source of infection was a sex worker. None acquired infection through his wife. The knowledge about STIs was very poor. Wrong notions were prevalent. Conclusions. The pattern of STIs is different from developed countries. Those acquiring STIs in Pakistan were older, married and living with their families whereas in developed countries most men acquiring STIs are younger, unmarried and living alone

Frequency of retinopathy among diabetics admitted in a teaching hospital of Lahore

Diabetic retinopathy is a complication of diabetes that affects the blood vessels of the retina and leads to blindness. Although 4 ' 8 million diabetics exist in Pakistan, very little work has been done on this complication of diabetes. The present study was undertaken to estimate the frequency of retinopathy among diabetics admitted in a teaching hospital of Lahore. Every patient of diabetes mellitus, admitted in departments of Medicine, Surgery, Ophthalmology and Obstetrics and Gynecology at Sir Ganga Ram Hospital, Lahore between June 2001 and September 2001 was included in the study. After adequate mydriasis, detailed fundus examination using indirect opthalmoscope was carried out to determine the presence of diabetic retinopathy and its type. Out of 4414 admissions, 540 patients ' 340 females and 196 males were diabetics. Among 540 diabetics, 132 had Type-1 diabetes [24.4%] while 408 had Type-2 diabetes [75.6%]. The duration of diabetes ranged from 10 to 12 years. The prevalence of diabetes among admitted patents was 12.2%. Among these 540 diabetics, 180 had diabetic retinopathy showing a prevalence of 33.3%. Non-proliferative retinopathy was present in 21.5% diabetics and proliferative retinopathy among 11.8% diabetics. The prevalence of retinopathy was significantly higher [P<0.001] among males [42.8%] as compared to females [27.9%]. The prevalence was similar [33.3%] among both Type-1 as well as Type-2 diabetes as well as similar to that reported from other countries. Since 33.3% of our diabetic population is suffering from retinopathy ' a condition amenable to timely and cost-effective treatment, every diabetic should be made aware of the importance of regular ophthalmologic examination

Perceptions of menopause among rural women of Lahore

The present study was undertaken to document the perceptions of Pakistani women regarding menopause. Design: Cross-sectional descriptive study. Place and Duration of Study:. The study was conducted in the suburb of Lahore from 1st July 2000 to 31st August 2000. Subjects and The data were collected from a rural population of 28,419 individuals living in 20 villages outside Lahore. A systematic random sample of 130 women was drawn from those 1337 women, who had reached natural menopause. In-depth interviews were conducted in local dialect. The age of the population ranged from 42 to 80 years with a mean of 59.8'7.4 years. The mean age at menopause was 49.0'3.6 years. Majority of the women [82.3%] considered menopause as a positive change. According to 71.6% women, their relationship with the family had either improved or there was no change. There was an increase in libido among 70.5% women, decrease in libido among 5.7% and no change among 23.8% women. However, 16.9% women reported dyspareunia. Seven% of the women suffered a fracture after menopause. None of the study subjects reported postmenopausal bleeding. Three women [2.3%] had cardiac ailments. The proportion of women showing a positive attitude towards menopause was significantly higher [p<0.005] among our study subjects as compared to those from India, Thailand, USA and Australia. The majority of study subjects did not consider menopause as a negative milestone, loss of time, a partial death or a disease as seen in many western populations. On the contrary menopause is regarded as a natural phase in a woman's reproductive life

prevalence of obesity among diabetic women

To ascertain the prevalence of obesity among newly diagnosed diabetic women, the medical records of 653 diabetic women were studied. These women were attending Diabetic Clinic established by Pakistan Medical Research Council at Fatima Jinnah Medical College, Lahore. A comparison was made with non-diabetic non-pregnant women living In the catchment area of the hospital.The mean BMI of diabetic women was 26.95'5.27 compared to 21.91'5.7] of non-diabetic women [P<0.005]. The prevalence of obesitv [BMI > 30] was 21.7% among diabetic women and 7.6% among non-diabetics [P<0.001]

Occurrence of lower urinary tract symptoms during pregnancy and their significance

A study was carried out between September 1997 and August 1998 to determine the frequency of occurrence of lower urinary tract symptoms in pregnant women and to establish their significance in relation to infection through bacteriological examination. About 47 percent did complain of having single or multiple lower urinary symptoms. There were 41 percent nulliparous and 59 percent multiparous women and in 52 percent cases gestational age was > 31 weeks. The most commonly encountered problem was abnormal voiding patterns found in 84 percent of participants, followed by irritative manifestation 47 percent, urinary incontinence 37 percent and voiding difficulties 10 percent. Significant pyuria [> 6 pus cells per high power field] was found in 19 percent cases and bacterial growth was demonstrated in 8 percent of women. The cases with positive bacterial growth mostly had the problems of increased diurnal frequency and/or nocturia, dysuria and urgency. Prevalence of hypertensive disorders of pregnancy was found to be significantly higher among these cases as compared to the cases who had no bacteriological evidence of cystitis

Trial of labour after caesarean section

Fifty six women, aged 20 to 34 years, who had previous cesarean births, were given a trial of labour. The labour was induced in 14.3% women while 65.7% women proceeded to spontaneous labour. The rate of vaginal delivery was 67.9%. Delivery was achieved through cesarean section in 75% of inductions and 25% of spontaneous labours. The overall cesarean rate was 32.1%. The most common indications for repeat caesarean was failure to progress [44.4%], foetal distress [27.7%] and failed induction [16.7%]. There was no maternal or foetal mortality and the trial of labour was associated with minimal maternal or foetal morbidity. The number of vaginal births prior to first caesarean section did not seem to influence the outcome. The success rate in the present study [67.9%] compares favourably with reports from other countries