Assessment of antimicrobial, antioxidant and cytotoxicity properties of Camellia sinensis L.

The phytochemical screening, antimicrobial, antioxidant and cytotoxic properties of Camellia sinensis were evaluated in the present study. The phytochemical screening revealed the presence of an applicable amount of lycopene, beta-carotenes, flavonoids and tannins in C. sinensis. Among the phytochemicals, tannin was found to be significantly higher in tea plant. The antimicrobial activity of plant extracts against selected bacterial strains namely, Escherichia coli, Staphylococcus aurous, Pseudomonas aeruginosa, Klebsiella pneumoniae, Acinetobacter baumannii, Marginella morganii and Haemophilus influenzae was investigated. The results showed that the stem part of C. sinensis presented greater antimicrobial potential than the leaf and root. Antioxidant activity [assessed through % inhibition of linoleic acid per oxidation test] was the highest [89.22%] in n-hexane extract of root part as compared to other extracts. Finally, the cytotoxicity analysis [haemolytic activity against human erythrocytes] of plant extract showed the negligible [%] lysis of RBCs ranging from 1.73 to 4.01%. In conclusion, it can be suggested that C. sinensis is the potential source to obtain bioactive phenolic compounds with high antimicrobial and antioxidant properties, which could possibly be exploited for the treatment of various infectious diseases

Use of smokeless tobacco in pregnant women

Objectives: To calculate the frequency of use of smokeless tobacco by pregnant women and determine their awareness about its hazards. Study design, settings and duration: Questionnaire based study conducted in the Obstetrics OPD of Isra university hospital. Hyderabad over 6 months from 1[st] January 2011 to 30[th] June 2011

Patients and Methods: All obstetric patients who came to the Obstetrics and Gynecology OPD during this period were enrolled and 302 of them were selected at random. A structured proforma was used to collect information like age, gravidity, gestational age, socioeconomic status, residence, occupation and literacy status. Starling age of use of smokeless tobacco, frequency of usage before and during pregnancy was also inquired. Women smoking cigarette were excluded. Data were analyzed on statistical software SPSS version 16. Frequencies and percentages were calculated, the final outcome was recorded

Results: A total of 302 pregnant women were interviewed. One hundred and sixty-four [54.3%] were using smokeless tobacco before pregnancy and they continued it throughout pregnancy except three, while 26 women started its use during pregnancy making a total of 187 [61.9%] women who were using smokeless tobacco during pregnancy. Usage was 2-3 times before pregnancy and remained same during pregnancy. The most common smokeless tobacco was Ghutka 116 [62%]. Hazards of using smokeless tobacco during pregnancy were known by 189 [62.6%] women and health care provider was the most common source of passing this information. Regarding social taboos, 240 [79.5%] pregnant women said that using smokeless tobacco is not acceptable for women

Conclusion: Majority of pregnant women were using the smokeless tobacco in spite of knowing the hazards of smokeless tobacco

An unrecognized complication of un safe abortion

We report a case of a 30-year old female who presented with uterine perforation with macerated fetus in the abdominal cavity with severe sepsis after an attempted unsafe abortion

Thrombocytopenia in pregnancy: an observational study

To determine the etiology, and outcome of thrombocytopenia in pregnancy. An Observational hospital based study was conducted at Isra University hospital Hyderabad for three years from 1[st] January 2009 to 31[st] December 2011. Total 3576 obstetric patients were admitted in Obstetrics and Gynecology department during this period of whom 71[1.9%] had thrombocytopenia in pregnancy. Depending on the number of platelets; thrombocytopenia was divided into four groups, i.e. those having platelets below 20,000, between 20-50,000, between 50-100,000 and more than 100,000. Patients with chronic liver disease and drug induced thrombocytopenia were excluded from the study. A predesigned structured proforma was used. All results were analyzed on statistical software SPSS version 16 Frequencies and percentages were calculated, the final outcome was recorded. The most common cause of thrombocytopenia was gestational thrombocytopenia seen in 24[33.8%] patients followed by HELLP syndrome 9 [26.7%] and hepatitis E in 10[16.3%] patients. There were 11 cases who had platelets below 20,000, 18 had levels between 20-50,000 and 19 had between 50-100,000. The common symptoms were bleeding seen in 30[42.2%] cases and purpura or easy bruising seen in 11[15.4%] cases while, 30 cases were asymptomatic. Of 11 cases that had platelets below 20,000, 10 mothers died along with their 7 babies while, only 3 surviving babies were those of mothers dying of post partum hemorrhage. Eighteen mothers had platelets between 20-50,000 and out of these 9 mothers and 11 neonates died. Nineteen mothers had platelets between 50-100,000 and out of these one mother and 3 neonates died. Overall maternal mortality was 20[28.1%]. Maternal and fetal deaths occurred in almost all cases with DIG, HEV and malaria while, in PPH mothers died but their newborns survived irrespective of platelet count. Diseases causing platelets below 50,000 in pregnancy should be rated as high risk pregnancies and dealt with accordingly to reduce high fetal or maternal mortality

Pap smear, an important screening tool to detect precancerous stage of carcinoma of cervix

Many women can be saved from carcinoma of cervix by detecting and treating its precancerous stage. Pap smear is cheap and easily available in majority of institutes. The objective of this study is to determine the frequency of abnormal Pap smear and role of Pap smear in detecting precancerous stage of cancer cervix in women. This is retrospective descriptive study was conducted in gynaecology outpatient department of Isra University Hospital, Hyderabad, Sind from Nov 2006 to Oct 2009. All women who presented in OPD with gynaecological complaints were included in the study. Pregnant women were excluded from the study. Smear was collected with an Aryes spatula and relevant information was obtained from the patient's record and recorded on pre-designed Performa. Slides were then sent to pathology department. Data were analysed through SPSS-15 and presented as frequency and percentage. Total 981 women underwent Pap smear screening. Majority [63.3%] of the patients belonged to age group of 31-40 years. One hundred and eighty [18.34%] smears were normal and 792 [80.7%] were abnormal. Among these abnormal smears, 739 [75.33%] smears were inflammatory while 4 [0.40%] women had Ca in situ and 4 [0.40%] had squamous cell carcinoma. Pap smear is an important screening tool to detect precancerous stage of carcinoma of cervix. It should be done periodically in all married and high risk women for early detection of a precancerous stage

Clinical audit of foetomaternal outcome in pregnancies with fibroid uterus

Leiomyoma, myoma, leiomyoma or fibroids are synonymous terms. They may be present in as many as 1 in 5 women over age 35 years. If pregnancy is associated with fibroids, it leads to multiple complications. Objectives of this study were to evaluate the maternal and foetal outcome in women having pregnancy with fibroids in uterus and the complications associated with fibroids during the pregnancy. This descriptive study was conducted in the Department of Obstetrics and Gynaecology, Ayub Teaching Hospital Abbottabad from March 2009 to March 2010. Data were collected on performa regarding demographic variables, obstetrical history, mode of delivery, maternal outcome, maternal complications, and foetal outcome. Mean and standard deviation was calculated for age, period of gestation, and obstetrical history. Frequency and percentages was calculated for booking status, maternal outcome, maternal complications and foetal outcome. Thirty patients were included in this study who had pregnancy with fibroid. Normal delivery was achieved in 14 [46.66%] patients. Eight [26.67%] patients had caesarean section and eight [26.67%] had miscarriages. Seven [23.33%] patients had no complications while 8 [26.67%] had miscarriages, 8 [26.67%] had postpartum haemorrhage, 10 [33.33%] had preterm delivery, and 3 patients had ante-partum haemorrhage. Two [10%] patients had premature rupture off membranes and 1 patient [3.33%] had pain abdomen and technical difficulty during caesarean section. There were 12 [40%] healthy babies. Five [16.67%] babies delivered with morbidity but recovered. There were 4 [13.33%] intrauterine deaths and one early neonatal death. Fibroid in pregnancy, especially multiple intramural fibroids and fibroids larger than 10 Cm, cause miscarriage and preterm labour.

Torsion of fimbrial cyst

A case of fimbrial cyst torsion is presented in an 18-year-old virgin female. She presented with severe left lower abdominal pain. Ultrasound scan was suggestive of an ovarian cyst. On laparotomy, a large 22 x 22cm twisted leftfimbrial cyst was found and a left salpingectomy was performed. Although torsion of fimbrial cyst is rare, it should be considered in the diagnosis of acute abdomen in females

Epidemiology of acute poisoning in children due to household substances. Mortality and morbidity in Hazara division

Acute Poisoning in children due to house hold substances is a global problem, however mortality and morbidity is nowadays very less in developed countries due to precautionary measures and better treatment facilities while situation in developing countries like Pakistan is alarming one. The present study was conducted to know about the death and injuries due to household poisoning in children in Hazara Division. The purpose of study was also too seek measures to reduce the risk factor. This prospective study was carried out in the Paedriatic unit of Ayub Hospital Complex and Department of Forensic Medicine and Toxicology, Ayub Medical College, Abbottabad from July to 2008 to September 2009. A total number of 6 leases of acute poisoning of children were brought to emergency department of Ayub Hospital Complex. 45 cases were admitted in Paedriatic unit while 16 were treated in emergency department were sent back to home. There were 37 male children [60.65%] and 24 [39.34%] female. The maximum number of cases were between age group 1-5 years 43 [70.49%]. 99% percent cases in our this study were of accidental nature only one case was homicidal nature while suicidal was none. Insecticide / rodenticide were the commonist agent ingested, followed by pharmacutical products. Kerosene oil was the third commonist agent ingested in our studies. Mortality rate was 3.27%. Organo-phosphorus compound [insecticide], rodentcide and kerosene oil [petroleum products] and pharmaceutical products are common source of household accidental poison globally. In developed countries there frequencies is decreasing rapidly due to health education and precautionary measures adopted mandatorily by manufacturers but in developing countries like Pakistan the situation is same as 50 years back. The risk factor can be reduced by adopting preventive measures at national level through health education of masses and parents and making products safety measures mandatory for manufacturers, moreover parents must be educated about the harms of some Herbal agents containing Opiates and on safe storage of medicines and house hold poisonous agents

Homicidal deaths and injuries by bomb blasts in Dera Ismail Khan

Bombs are explosive devices used for homicidal purposes. The present study was conducted to know about the death and injuries due to bomb blasts in Dera Ismail Khan. This descriptive study was conducted from January 2007 to December 2008. The data was collected from autopsy and medico-legal records of all dead and injured persons at DHQ Teaching Hospital and Department of Forensic Medicine Gomal Medical College, D. I. Khan. Three hundred and forty-one un-natural deaths were reported and subjected to autopsy examination during the study period. Homicidal deaths constituted 256 [75%] of all autopsies. Out of homicidal deaths 82 [32.96%] were caused by blast injuries. Similarly 2153 injured persons were examined and recorded in the medico-legal register. Out of whom 253 [11.75%] were due to bomb blasts. In death cases, 461 injuries were found in various body regions giving an average of 5.62 injuries per person, and in injured person the number of injuries was 659, with average of 2.6 injuries per person. Lower extremities sustained the highest number of injuries both in dead and injured ones, followed by the head and neck injuries in dead and upper extremity injuries in the injured ones. Death due to bomb blasts are the second major cause of homicidal deaths after firearm in Dera Ismail Khan. Lower extremity injuries are the commonest in both dead and injured persons, followed by the head and neck injuries in dead and upper extremity injuries in the injured ones

Effectiveness and safety of vaginal misoprostol for induction of labour in unfavourable cervix in 3[rd] Trimester

The use of prostaglandin preparations with or without oxytocin infusion, is widely recognized and accepted as a standard method of induction of labour. It has been shown to reduce induction time and the risk of failed induction. The objective of this quasiexperimental observational study was to determine the effectiveness and safety of Misoprostol administered vaginally for induction of labour to achieve vaginal delivery. This study was conducted from October 2004 to October 2007. The study was conducted at Shaheena Jamil Teaching Hospital, Frontier Medical College, Abbottabad and Women and Children Hospital Abbottabad. A total of 6299 obstetric patients were received for delivery and 946 patients had to undergo induction of labour. Primary outcome measures were to address clinical effectiveness [delivery within 24-hours] and safety [uterine hyper-stimulation, Caesarean Section and serious Maternal Morbidity]. Secondary outcome measures included neonatal outcome. Out of 946 cases, successful vaginal deliveries were achieved in 843 [89.1%] cases. Time interval between induction and delivery was 4-24 hours. Oxytocin was required in 107 [12%] patients. Caesarean Section had to be done in 103 [10.8%] cases. The indications for Caesarean Section were foetal distress in 42 [40%], occipito-posterior position in 8 [7.7%], abruptioplacentae 2 [1.9%], cord around the neck 9 [7%], uterine hyperstimulation 6 [5.8%] and failure to progress in 20 [19%] cases. Admission to NICU was 28 [3.3%] and Neonatal deaths were 5 [0.5%]. Postpartum Haemorrhage [PPH] was observed in 22 [2.3%] patients. There was no case of rupture uterus. Vaginal Misoprostol appears to be safe and effective for cervical ripening in third Trimester. It helps vaginal delivery within 24 hours, does not increase incidence of Caesarean Section and has no adverse effect on foetal outcome. It could also be used in circumstances where extensive monitoring techniques are not available though close observation and vigilance is mandatory

Maternal and neonatal outcome of ventouse delivery at Ayub teaching hospital, Abbottabad during the year 2005 to 2006

To study the maternal and neonatal outcome of assisted vaginal delivery with vacuum extractor [ventouse]. This prospective study conducted in the department of obstetrics and gynaecology. Unit A, Ayub Teaching Hospital, Abbottabd included hundred consecutive cases of successful ventouse deliveries from May 2005 to April 2006. There were minimum [16%] maternal and neonatal complications during this study. As no serious maternal and neonatal morbidity noted during the study period, vacuum extractor should be the instrument of first choice for instrumental vaginal delivery

Combined abdominal hysterectomy, cholecystectomy and appendicectomy: a study of 25 cases in Abbottabad

Gallstone disease is common in women. Many patients undergoing abdominal ultrasound for gynaecological diseases are found to have gallstones. This study was done to see the results of combined abdominal hysterectomy, mini-cholecystectomy and appendicectomy in a set up lacking facilities of laparoscopic surgery. This prospective study was conducted in Ayub Teaching Hospital, Iltaf Hospital and Shahina Jamil Trust Hospital of Abbottabad from August 1998 to July 2004. All patients undergoing combined abdominal hysterectomy and mini-cholecystectomy were exclusively studied with reference to following variables. Age, Weight, Parity, Co-morbid conditions, peri-operative and post-operative complications, blood transfusion, hospital stay and mean extra time for mini-cholecystectomy and appendicectomy after abdominal hysterectomy. There were 25 patients in the study group. The ages ranged from 35-50 years. Mean weight was 65 Kg. There were no operative complications. Mild postoperative complications occurred in 7[28%] patients. Mean extra time for cholecystectomy was 25 minutes. Mean hospital stay was 9 days. In selected women, combined abdominal hysterectomy, cholecystectomy and appendicectomy is a safe, feasible and cost effective procedure

Uterine rupture: a review of 34 cases at Ayub teaching hospital Abbottabad

Uterine rupture is a deadly obstetrical emergency endangering the life of both mother and fetus. This descriptive study was conducted to determine the frequency of ruptured uterus at Ayub Teaching Hospital Abbottabad and to elicit possible causes/reasons of ruptured uterus. The study was conducted at the department of Obstetrics and Gynaecology, Ayub Teaching Hospital, Abbottabad, Pakistan over a period of one year from July 1st, 2001 to June 30th, 2002. All cases of uterine rupture presenting during the study period were recorded and managed in the department using a protocol prepared for the purpose of this study. Data was recorded on pre-designed Proforma. There were 34 cases of ruptured uterus out of a total of 3435 deliveries [including 1128 Caesarian sections] over a one-year time period [incidence of 1/100 deliveries] with 31 intra-partum deaths. The most common age group was from 31'35 years [16/34, 47%], followed by the 26'30 years age group [13/34, 38.2%]. A majority [29/34, 85.3%] were cases of unscarred uterus presenting with rupture; the most common cause of rupture in all cases was inappropriate injections of Oxytocin [11/34, 32.35%], followed by obstructed labour [9/34, 26.5%]. All were anemic and most of them were in shock. The leading cause of ruptured uterus was found to be mismanagement by traditional birth attendants. We can reduce maternal mortality due to rupture uterus by giving proper training to traditional birth attendants and by mass education through electronic media