ABSTRACT
Objective:To compare the efficacy of titrated oral mis oprostol solution with intravenous oxytocin for augmentation of labour in term primigravidae in active phase of labour with inadequate uterine contractions
Methodology:This randomized control trial was conducted in the department of Gynaecology and Obstetrics, Pakistan Institute of Medical Sciences, Islamabad, over a period of six months from 14-April to 13-October, 2014.A total of 760 [two groups of 380 each] primigravidae, between age 20-39 years, who had completed 37-42 gestational weeks by dates, or by ultrasound scan, with regular contractions and an effaced cervix dilated between 3-4 cm, and who later developed inadequate uterine contractions during the first stage of labour were included in the study. Group A received titrated oral misoprostol solution 200ìg tablet dissolved in 200ml tap water and 20ml [20ìg/hour] and group-B was given Intravenous oxytocin [10 units in 1000cc Hartman's solution at 8 drops/minute, doubling every 30 minutes up to a maximum of 64 drops/min for 2 hours]
Results: Mean [+/-SD] age of the patients was 26.4+/-4.4 and 26.6+/-4.6 years in group-A and B respectively. In group-A, 322 patients [84.7%] and in group-B 326 patients [85.8%] were delivered vaginally. Mean [+/-SD] augmentation to delivery interval was 293.82+/-99.36 and 311.65+/-106.73 minutes in group-A and B respectively. Mean [+/-SD] gestational age in group-A was 38.82+/-1.32 and in group-B 38.83+/-1.09 week. Caesarean section was performed in rest of the patients in both groups. There was no significant association between mode of delivery in both groups [P-value= 0.682]
Conclusion:Labour augmentation with titrated oral misoprostol or intravenous oxytocin resulted in about similar rates of vaginal delivery
ABSTRACT
A male child of four years is reported with Williams-Beuren Syndrome [WBS]. It was not recognized initially when he presented with odd facies and developmental delay since early infancy. The diagnosis was established later when he developed hypertensive encephalopathy secondary to bilateral renal artery stenosis, a congenital anomaly that must be looked for in such patients. No echographic evidence of congenital heart disease was found. Blood pressure estimation on routine physical examination of every child is emphasized. The diagnosis is mainly clinical as the definitive chromosomal studies are presently not available in Pakistan
Subject(s)
Humans , Male , Williams Syndrome/diagnosis , Renal Artery ObstructionABSTRACT
To determine frequency of IVH in premature infants delivered at Military Hospital Rawalpindi. Descriptive study. The study was conducted in the Neonatal Intensive Care Unit at Military Hospital Rawalpindi. From September 2006 to February 2007. In this study 100 premature babies were included. High frequency ultrasound was used for evaluating IVH because of its non-invasive nature, easy availability and conveniences. A total of 100 babies were included in the study. Sixty-one babies were delivered by spontaneous vaginal delivery [SVD] while 39 babies by lower segment cesarean section [LSCS]. Mean gestational age was 32.3 +/- 2.12 weeks. Mean birth weight of the babies was 1637.7 +/- 349.25 grams. Total 11 cases of IVH were detected in study. Frequency of IVH was 11% in premature infants. We suggest that any premature infant born before 32 weeks gestation or weighing <1500g should be evaluated for IVH by cranial ultrasound
ABSTRACT
To determine the frequency of accidental poisoning by various agents and their associated outcome in children. Descriptive Study. The study was carried out in emergency department at PNS Shifa hospital Karachi, from January 2007 to December 2008. A total of 200 patients reported with accidental poisoning during the study period. Detailed history and examination regarding the nature of poisoning was taken. Relevant investigations for purpose of diagnosis were carried out. Mortality and morbidity was noted on predesigned proforma. Total 200 patients were admitted with accidental poisoning during the study period. 155[77.5%] of patients belonged to less than 5 year age group. Most frequently ingested poison was kerosene oil [51%], followed by insecticides [17.5%], Oral route was involved in majority of cases 194[97%]. Complications were observed in 6% of cases, Pneumonia was the most frequently occurring complication in 8 [4%] cases of kerosene oil ingestion, followed by seizures in 2 [1%] cases of insecticide ingestion. No mortality was reported in this study. Acute childhood poisoning is a significant public health problem affecting mainly toddlers. Main substances responsible for acute poisoning are Kerosene oil, insecticides, bleach and drugs