ABSTRACT
To compare the maternal and neonatal morbidity between vacuum extraction versus forceps vaginal delivery. Quasi-experimental study. January 2009 to December 2010. Setting: Department of Obstetrics and Gynecology CMC, SMBBMU Larkana. All patients delivered by forceps or vacuum with singleton pregnancy were included, the patient with multiple gestation, breech presentation and gestational age less than 34 weeks were excluded. Data collected in pre-set Proforma include type of instrument used, indication of instrumental delivery, maternal and neonatal complications of procedure. Data was analyzed; frequency and percentage will be calculated for maternal age, gestational age, and degree of perineal and cervical tears. .chi-square test was applied to compare the degree of neonatal and maternal complications. P-value less than 0.05 taken as significant. Total 9, 5600 deliveries were conducted, among them assisted vaginal deliveries were169 making the frequency of 2.66%, among which 96 have forceps and 64 were ventouse vaginal deliveries. Majority of women were primigravida. In infants of less than 37 weeks of gestation the use of forceps was significantly more common, delay in second stage of labor was the most common indication for vacuum extraction while fetal distress was more common reason for forceps delivery. Severe birth canal injuries [third and fourth degree perineal tears] and procedure related blood loss of more than 500 ml was significantly more common in forceps delivery group. Cephalhaematoma, neonatal jaundice and severe caput succedanum at discharge were more seen in vacuum deliveries, but facial injuries were more common after forceps delivery. Intracranial hemorrhage was identified in two infants born by vacuum extraction and none in forceps group. Two infants delivered by vacuum extraction expired, one due to respiratory distress and other due to intracranial hemorrhage, and one of the infants delivered by forceps expired due to meconium aspiration syndrome [MAS]. Each instrument has its own merits and demerits .Maternal and neonatal outcome depends on indications of instruments, patient selection and skill of operator. We conclude that forceps delivery is more associated with maternal genital tract trauma and vacuum delivery is associated with more neonatal complications. So it is the choice of obstetrician to select the proper instruments. We also suggest that obstetricians learn these skills not on patients but in a skill laboratory using models
ABSTRACT
The aim of this study is to observe the anti-ulcer effects of Abietic acid [a compound of Cedrus deodara] on the histopathology of rat's stomach in comparison with standard anti-ulcer drugs such as Femotidine [H2 receptor blocker] and Protonix [a proton pump inhibitor]. Experimental study. This study was conducted in the department of Pharmacology, Institute of Pharmaceutical Sciences, Baqai Medical University, Karachi. This study was carried out on 50 albino rats of Wistar Strain for experimental purpose. The animals were divided into five groups and each group comprised of 10 rats [i.e. 5 male and 5 female]. The experimental procedure was repeated for three times. The compound of abietic acid was provided by the chemistry department of Karachi University. The ulcer was induced in the animals by giving 1ml of 100% ethanol after 48 hrs of fasting. The induction of ulcer in animal was then treated with abietic acid [25 mg/kg for 2 weeks] orally through feeding tube. The ulcer healing effects of this compound were then compared with the effect of known anti-ulcer drugs. Abietic acid used in this study showed the healing effects on the mucosal epithelium of stomach, decreased inflammatory cells and formation of granulation tissues on the sub mucosal layer during histopathological examination. It is thus concluded that abietic acid has an anti-ulcerative effects when given in the required dose and may be adapted in the management of gastrointestinal disorders particularly in peptic ulcer