Toxic metals in maternal blood, cord blood and meconium of newborn infants in Pakistan

Toxic metals and deficiency/excess of trace elements can have adverse effects on health. The aim of this study was to quantify toxic metals lead, cadmium and trace elements zinc, copper, aluminium [Al] and Iron [Fe] levels in pregnant women, cord blood and meconium of new-born infants from industrial zones of Karachi, Pakistan. Analytical research was performed from 2011–2012 in low socio-economic pregnant mothers and newborn infants from 20 towns near Sindh Industrial Trading Estates, Federal B industrial area and Korangi industrial areas, Karachi, where environmental pollution was anticipated. Blood samples of pregnant women [n = 416], cord blood [n = 309] and meconium [n = 309] were analyzed quantitatively for metals and trace elements. Results indicated that mothers residing in steel towns were found to have the highest levels of lead. Meconium contained high levels of toxic heavy metals and trace elements compared to cord blood and maternal blood. Maternal blood toxic metals were present in high quantities. Therefore, safety measures should be taken when industrial waste is disposed of in order to prevent population contamination

Changing prevalence of cesarean section, repeated cesarean section and indications for repeated cesarean section over 10 year period at a tertiary care center, Karachi

Objective: To study the change in frequency of cesarean section, repeat cesarean section and the indications for repeated cesarean section after 10 years at a tertiary care center in Karachi

Methods: This study was conducted in the department of Obstetrics and Gynaecology, unit 1, Abbasi Shaheed Hospital. This retrospective analysis used departmental records to compare cesarean section rates for 2 years, 10 years apart. i.e. 2002 and 2012.The study thus spans a twelve month period extending from 1st January 2002 to 31st December 2002 and twelve months from 1st January 2012 to 31st December 2012.Using data from both study periods women who had successful vaginal birth after cesarean and women who had a repeat cesarean section were determined. Additionally, the rate of repeat cesarean section and indications for repeat cesarean section were analyzed for each study period

Results: In year 2002, 411 out of 1425 total births had cesarean. The cesarean section rate was 28.8%, whereas in 2012, the cesarean section rate was 44% [615 out of 1212 total births]. Ninety-two out of 411[22.38%] in 2002 had prior cesarean section, whereas 192 out of 615 [44%] had prior cesarean section in 2012

In those with previous cesarean section, successful vaginal birth after Cesarean section was 38% in 2002 and 21.88% in 2012. The leading indications for repeat cesarean were non-progress of labour, fetal distress and scar tenderness. Maternal wish contributed to 4.6% repeat cesareans in 2012, whereas only 1.7% of study population desired repeat cesarean section in 2002

Conclusion: Cesarean rates are on the rise in this tertiary care center of Karachi. As compared to ten years back, the rate has risen from 28.8% to 44%. The overall high section rate at this center may be accounted for by the fact that it deals with high risk Obstetrics and referred cases from Karachi and the province of Sindh. However, 16% rise in overall cesarean is quite dramatic

Oral hygiene and gestational age at delivery; A cross-sectional survey conducted at a tertiary care hospital

Objective: Assessment of the oral hygiene and addiction habits of postpartum mothers and its relationship with the gestational age at delivery. Method: It was a cross sectional study carried out as a survey of postpartum mothers after having delivered term and preterm newborns. It was conducted between January 2008 - January 2009, at Gynae Unit I of Abbasi Shaheed Hospital and Karachi Medical and Dental College. The total number of postpartum mothers were 189, of which 155 had term delivery and 34 had preterm delivery. The data was collected on a predesigned questionnaire after taking informed verbal consent. The questionnair included demographics such as age, parity, oral hygiene status, brushing habits, addictions, and gestational age at delivery. All the participants were interviewed and findings were recorded on the questionnaire. Results: The data was entered in SPSS version 20. The mean age of women was 27:30 +/- 4.75 years. Of the total 189 postpartum mothers, 106 [56.1%] mothers with term babies had good oral hygiene; 49 [26%] mothers with term babies had poor oral hygiene; 13 [6.9%] mothers with preterm babies had good oral hygiene; and 21[11%] mothers with preterm babies had poor oral hygiene [p<0.0001]. In terms of addiction to smokeless tobacco, etc, 41 [21.7%] addict mothers had term babies while 9 [4.8%] addict mothers had preterm babies. Amongst the 139 mothers with no addiction, 114 [60.3%] mothers had term babies while 25 [13.2%] mothers had preterm babies. The p-value came out to be 0.9982 in this regard. Conclusion: This study suggests that poor oral hygiene of mothers is likely to result in preterm delivery of babies

Premenstrual syndrome: a comparative study of working women vs housewives in Karachi

To compare the frequency of premenstrual syndrome [PMS] in working women and house wives and its relationship with associated factors. A comparative cross sectional study having qualitative characteristics, was conducted in Karachi form August 2002 to August 2003. Working women in the study were from Abbasi Shaheed Hospital and-house wives from Federal B Area Karachi. Hundred women were included aged between 20-40 years belonging to two groups of 50 each. The first group comprised of working women from a hospital, ranging from highly educated doctors to janitors. The other group comprised of non-working housewives of middle and low income group. In both groups exclusions were made for those who had irregular menstrual cycle, on contraceptive pills, desiring pregnancy, were lactating or had known major psychiatric or medical disorders. Results were compiled after three consecutive menstrual cycles using questionnaire. The results indicated that PMS is significantly higher in working women than housewives [50% vs 30%]. Statistical analysis showed that it is more commonly present in the age range of 26-35 years, in single women or women with low parity and the well educated. Irritability, depression and loss of interest are most frequent complaints in working women. General malaise, abdominal cramps and dysmenorrhoea are more common in house wives. Working women show greater tendency to use analgesics. PMS was more common in working women compared to housewives. There is a need to identify women with PMS and to establish an intervention that would help to alleviate the symptoms so that their work performance remains unaltered

screening for cervical cancer by pap smear in hospital based population

The aim of the study was to screen sexually active women of cancer of cervix by Pap smear and to find the proportion of preinvasive and invasive disease of the cervix in a hospital based population. Cross sectional study. This study was conducted from 1 june 99 to 31 December 2000 at Department of Obs and Gynae unit 1 to Abbasi Shaheed Hospital and Karachi Medical and Dental College. The study included [ 152 ] sexually active women attending the gynae OPD of ASH. The patients were screened fort cancer of cervix by the standard screening test, the pap smear. The result of the smears were analyzed. Out of 144 smears considered for analysis 44 [ 30.55% ] were normal, 87[60.44%] showed inflammatory changes, 6[4.16%[ had dysplasias and more than 7[4.86%] were classed as inadequate because of absence of endocervical cells. A pap smear detects cervical cancer in its early [curable ] stage it is thus recommended that an effective screening programme should be introduced at national level and awareness must be created in women regarding screening of cervical cancer

Effects of first and second trimester vaginal bleeding on pregnancy outcome

The effects of vaginal bleeding during first and second trimester on pregnancy outcomes was assessed in a hospital-based population of 268 non-diabetic women. The group of non-bleeders comprised 173 females whereas, there were 71 females with first and 24 with second trimester bleeding. Fetal loss [abortion] occurred in 34% of first trimester and 25% of second trimester bleeders. Low birth weight and preterm delivery were significantly associated with second trimester haemorrhage. The results suggest that first and second trimester vaginal bleeding correlates with adverse infant outcomes

Anaemia in pregnancy-its cause in the underprivileged class of Karachi

A prospective study of the frequency and type of anaemia amongst poor urban parturients of Karachi was done. It was performed at 2 large teaching hospitals over the time span January to September, 1990. Out of 318 women studied, 104 [32.7%] were anaemic [Hb levels < 10gm/dl]. The type of anaemia was assessed. Iron deficiency predominated and was seen amongst 63.5% of the anaemic population. There was an even distribution of other kinds of anaemia amongst the remainder of the population