Frequency of hepatitis C in general surgical patients at teaching hospital Khairpur Sindh

Viral hepatitis is a global issue. Hepatitis C virus is worldwide public health problem. This is related to the continued occurrence of new infections and the presence of a large reservoir of chronically infected population. To observe the frequency of Hepatitis C virus [HCV] infection and find out the risk factors in general surgical patients. Prospective Observational type. This study was carried out in the Surgical Department of Ghulam Muhammad Mahar Medical College Teaching Hospital KhairPur Sindh during one year period from May 2012 to April 2013. All patients admitted in surgical department either for emergency or elective surgery was included in the study. All patients were screened for HbSAg and Anti-HCV by using immumochromatography [ICT] method. The data of sero-positive patients for hepatitis C were taken for further study. The data was collected through pre- designed Performa and analyzed through SPSS version 15. Total 1030 patients were admitted in surgical department for emergency or elective surgery. During screening Anti-HCV +ve was found in 165[16.0%] patients. Out of these, 95[9.2%] were male and 70 [6.7%] were female. Mean age of these patients was 40.7 years. Among positive patients, most belongs to rural area with poor socioeconomic status. Multiple injections by quacks, shaving by barbers, history of blood transfusion, previous surgery were found to be risk factors in male, while in female history of Gynae and obstetrics procedure, partner +ve for HCV, blood transfusion were found main risk factor. No any risk factor was found in 20 [12.1%] male and 35 [21.2%] females. In the absence of any vaccine for Hepatitis C virus, emphasis should be made on health education and about the risk factors for virus transmission. Health care providers must be committed in the formulation of policies and strict adherence to the safe practices

Randomized controlled trial on prevention of postpartum haemorrhage with sublingual misoprostol or oxytocin

Failure of the uterus to contract adequately after child birth [a tonicity] is the most common cause of postpartum hemorrhage and misoprostol produces a rapid peak concentration, and is more effective than oral administration. We compared the postpartum blood loss with 400microg sublingual misoprostol and after standard care using 10 iu intramuscular oxytocin. Randomized controlled trial. This study was conducted in a Department of Obstetrics and Gynecology Ghulam Muhammad Mahar Medical College Teaching Hospital Khairpur Sindh during 2011. 60 women for each group were assigned to receive the study medications with in 1 minute of clamping and cutting the cord. Chi-square and studentt-test were used to test categorical and continuous outcomes. Mean postpartum blood loss and PPH [>500ml], >10% pre- to postpartum decline in hemoglobin and reported side effects. The mean estimated blood loss with sublingual misoprostol was 200 +/- 125ml [n=60] and 360 +/- 136ml with oxytocin [n=60] P-value 1000 ml of blood. Hemoglobin decline of > 10% observed that 11.6% and 45.0% in women after receiving misoprostol and oxytocin [P

Fetomaternal outcome of pregnancies complicated by acute appendicitis

To observe the frequency and Fetomaternal outcome of pregnancies with acute appendicitis. Prospective / observational study. This study was conducted in gynecology and surgical department of Ghulam Muhammad Mahar Medical College Teaching Hospital Khairpur Sindh from January 2010 to December 2012. All pregnant ladies admitted in Gynae and surgical department with history of acute pain in abdomen and strong suspicious of acute appendicitis on the basis of history, clinical examination and ultrasound findings after exclusion of other gynecological and surgical causes of acute abdomen during pregnancy were included in the study for following variables: Presentation, duration of symptoms, operative findings and complications associated with disease and operative procedure were noted. Data was collected on pre-designed Performa and analyzed on SPSS version 15. During 3 year study period total 8700 Obstetric admission and cases with strong suspicious of acute appendicitis in. pregnancy was 20 [0.22%], most women belongs to age between 18-40 years. More cases seen 2[nd] trimester 11[55%], duration of symptoms < 24 hours seen in 85% and >24 hours seen in 15% of cases. Abdominal pain was leading symptom present in 80% of cases while lower abdominal tenderness was leading sign seen in 90%. On surgery signs of acute appendicitis seen in 75%, normal looking appendix in 10%, while perforated appendix with moderate pus in peritoneal cavity seen in 15% of cases. One maternal death was seen in study population due to septicemia, most probably because of late presentation. The evaluation of a pregnant woman presenting with acute abdominal pain warrants a careful workup due to the possible risks for the fetus and mother if appendix perforates