use of vaginal misoprostol to terminate the pregnancy in second trimester

To determine the effectiveness of vaginal Misoprostol for the second trimester termination of pregnancy. Prospective randomized trial. This study was carried out in the Unit of Post Graduate Medical Institution Peshawar I aJv Reading Hospital Peshawar from 1[st] January till 31[st] December 2006. A total of 100 patients were included in this study. Misoprostol 400 microgram, was dministered intra-vaginally and repeated after every 4 hours up to a maximum of five doses or until the termination of pregnancy, which ever was earlier. The exclusion criteria were as allergy to prostaglandin, a previous classic caesarean section or Hysterectomy, active vaginal bleeding, severe asthma and epilepsy. Period of gestation ranged from 12 to 20 weeks, Indications for 2' trimester termination of pregnancy .ere chromosomal or structural fetal anomalies [anencephaly] whether dead or alive, missed abortion intrauterine fetal death. Success rate at 48 hours was 90%. The median induction to termination interval was 16 hours. Few Aomen suffered gastrointestinal side effects such as nausea [6%], vomiting [3%] and diarrhea [1%]. 400 Microgram of Vaginal Misoprostol is highly effective way of cervical ripening and termination of second trimester pregnancy

Active versus conservative management of prelabour rupture of membranes at term

To compare maternal and foetal outcome of active versus conservative management of premature rupture of membranes after 37 completed weeks of pregnancy. This quasi-experimental study was carried out at Gynae unit, Lady Reading Hospital, Peshawar from September 2004 to September 2005 and included 100 patients out of which 50 were managed conservatively and 50 actively. After confirming the leakage of amniotic fluid, patients were randomized by lottery method to conservative or induced group. The patients in the group that was managed conservatively were shifted to obstetrical ward to await the onset of regular uterine activity for at least 48 hrs. After Bishops scoring, patients were induced with vaginal prostaglandin E2 tablet. Both groups received intravenous antibiotics. Total number of patients with PROM at term was 3.84%. Total cost of stay in hospital and management was greater in induced group [P. value <0.05%]. Latent time was short in induced group whereas hospital stay was prolonged in induced group. About 80% of patients in conservative group delivered by NVD as compared to 60% in induced group. Among complications mild fever and PPH were significantly [P. value <0.05] more common in conservative group. There was neither neonatal death nor stillbirth in both groups. No statistically significant difference [P. value >0.05] was observed in respect of perinatal outcome and infectious morbidity in babies. Conservative management of PROM at term should be viewed more positively for at least 48 hrs under appropriate antibiotic cover and with active management of 3[rd] stage of Labour

Management of congenital nasolacrimal duct obstruction with massaging and probing without general anesthesia

Management of congenital nasolarcimal duct obstruction with massaging and probing without general anesthesia. Retrospective as well as prospective study. This study was carried out in the out patients department of DHQ teaching hospital charsadda for the period of nine months between 2010 and 2011. Total number of children/infants was fifty. All suspected patients were carefully examined and divided into two groups. Statistically analysis was done by student's "t" table. When results were summed up and test parameters were separated it was seen that the success rate with sample massaging and use of topical antibiotic was 90% at the end of nine months. Five infants improved with single probing. Infantile epiphora due to nasolacrimal duct obstruction generally cured with auto canalization/ massaging with topical antibiotics at the age of 5 months. The 2[nd] thing in this study that we can use topical anesthetic agent instead of exposing the infant to the hazard and the complication of general anesthesia

audit of post operative complications of elective abdominal hysterectomies

To record common post operative complications their risk factors. Obstetrics and Gynaecology unit of DHQ hospital Timergara lower Dir, from 1/01/2006 till 30/12/2006. The complications were recorded on a pre constructed Performa showing demographic data of patient, history, general health, indication for operation and surgeon rank. The Patients were divided in to three groups: A, B and C. Group - A: Complications occurring after operation with in the first 72 hours. Group - B: Complications occurring after and 12 hours but with in hospital stay Group - C: And complications recorded at follow up visit after 6 weeks. Our study showed the over all complications rate of 48.7% which is a significant rate, mortality were 4 out of 478 cases [8.36/1000]. The rate of complications was high in those women who had other associated medical problems, which can be reduced or avoided by Proper Pre-operative assessment, management and Technical factors under surgeon's control

Maternal and foetal complications in neglected transverse lie

To see the frequency of foetal and maternal complications of neglected transverse lie at a tertiary care hospital. This prospective study was conducted at Gynae B Unit Department of Gynaecology and Obstetrics Lady Reading Hospital Peshawar, Pakistan, from 1st January I997, to 31st December I997. Eighty-seven Patients presenting with neglected transverse lie were included in this study. Detail information regarding name, age, address, parity, past history, physical, abdominal and vaginal examination findings, general management and specific managements like internal podalic version, caesarean section, foetal complications and maternal complications of neglected transverse lie were entered into a predesigned proforma for the purpose. The maternal complications in order of frequency were dehydration 86.5% [n=77], pyrexia 41.37% [n=36], wound sepsis 31.03% [n=27], antepartum haemorrhage [APH] 16.09% [n=14] and postpartum haemorrhage [PPH] 14.94% [n=13] and maternal death 1.14% [n=1]. The foetal complications of neglected transverse lie were fresh stillbirth 55.17% [n=48], prematurity 14.94% [n=13], alive with poor Apgar score 10.34% [n=9], macerated stillbirth 8.04% [n=7], neonatal death 3.44% [n=3], post mature and alive 2.29% [n=2] and congenital malformation 2.29% [n=2]. Emergency lower segment caesarean section was done in 58 [66.7%] cases, while internal podalic version followed by breech extraction was done in 21 [24.1%] cases. Neglected transverse lie is associated with various maternal and foetal complications. Prenatal examinations are essential to reduce the unfortunate complications of transverse lie