Prevalence of osteoporosis in postmenopausal women visiting police and services hospital, Peshawar, NWFP

To determine the age of menopause and to find out the prevalence and risk estimation of osteoporosis in outpatient setting. Two hundred and forty postmenopausal women were recruited in a descriptive study. Postmenopausal women visiting outpatient department in Police and Services Hospital Peshawar, N.W.F.P. as patients or their relatives were interviewed on the pattern of preset questionnaire. The study period was from 1st Oct 2006 to 30th March 2007. The proforma covering demographic variables, social history, past medical history, drug history, age of menarche, age at menopause, reproductive history, family history of osteoporosis, was set up. The bone mineral density of heel was measured by bone densitometer Osteoporosis was defined on basis of WHO criteria. The mean age of menopause observed was 49.1 +/- 5.8 years. Early and late onset of menopause was associated with development of osteoporosis, while normal onset of menopause was found to be linked with osteopenia or bone mineral density remained normal. Only 14.48% women had normal bone mineral density. Approximate forty four percent postmenopausal women were suffering from osteopenia and 24.5% were having T-score in osteoporotic range. There is intense need to make women aware of osteoporosis, and its complications in form of fractures and lack of mobility. Osteoporotic bones can never be restored, so there should be early screening of menopausal women

Maternal and fetal outcome in undiagnosed and diagnosed singleton breech presentation at term

To find out the maternal and fetal outcome in undiagnosed and diagnosed singleton breech presentation at term. This study was conducted at Lady Reading Hospital, Peshawar from 1st July 2000 to 30th June 2001 on patients presenting with singleton term breech. Multiple pregnancy and preterm breech were excluded. Information regarding,age, address, parity, gestational age, physical and vaginal examination, ultrasound findings, mode of delivery, any specific procedures performed including external cephalic version [ECV] was collected. Demographic variables and obstetrical outcome were observed in diagnosed and undiagnosed breech cases.Diagnosed breech cases were diagnosed antenatally and proper management plan decided, while undiagnosed breech cases were unbooked who came to hospital for 1st time in labour. Out of 203 cases, 163 [80.29%] patients presented with undiagnosed breech and 40[19.71%] had been diagnosed in antenatal clinic. Out of 163 undiagnosed cases, 137 [84.1%] had successful vaginal breech delivery [VBD], 22 [13.5%] cases had caesarean section [CS], three [1.8%] had subtotal hysterectomy for rupture uterus and 1 [0.6%] with successful ECV had normal vaginal delivery [NVD]. Among 40 diagnosed cases, 8[20%] had successful VBD, 22 [55%] had CS and 10 [25%] had successful ECV followed by NVD. There was no statistical significant difference in short term neonatal outcome, neonatal morbidity and mortality among both groups. Maternal morbidity was lower in vaginally delivered undiagnosed breech cases than in those delivered by caesarean section.In diagnosed group maternal morbidity was the same regardless of mode of delivery. Good prenatal care is essential to reduce undiagnosed breech cases at term. ECVreduces the incidence of Breech Presentation at delivery. In selected cases VBD is a safe option