Role of extra calories on the birth weight of neonates - the nutritional value of dates in pregnancy

Date fruits [khajoor] are exclusive source of high nutrition to every individual and have been cultivated in Arab world for centuries. In addition to the dietary benefits of date fruits, they also possess important pharmacological properties. A community based study was carried out to assess the effect of date fruits intake on the selected group of pregnant and lactating women who belong specifically to the rural population of Karachi. The aim was to evaluate the weight gain of pregnant and lactating women as well as their infants after taking dates for a set period of time. The results indicated a significant weight gain of newborns and increase levels of hemoglobin in mothers. Hence, the study concluded the importance of dates as a good nutritional supplement particularly in the under developed areas

An azoospermic male can father a child

This study included 184 azoospermic men who visited Baqai Institute of Reproduction and Developmental Sciences [BIRDS] during a period of 20 months [October 1997 to July 1999]. Sperms were retrieved in 65 men by Percutaneous Epididymal Sperm Aspiration [PESA] and in 28 men by Testicular Sperm Excision [TESE]. Motile sperms were obtained in 42 men by PESA [65%] whereas in 9 men by TESE [32%]. Intra Cytoplasmic Sperm Injection [ICSI] was used in 28 cases where sperms were obtained by PESA. 252 oocytes were injected by ICSI and fertilization was noted to be 67.5%. Sperms obtained through TESE were used in 25 cases ofICSI. 289 oocytes were injected and fertilization was 61.6%. Patients were selected after full investigation and counseling. Patients having high serum FSH level and atrophied testis were not included in the study. Four pregnancies were obtained in PESA cases [14.2%] and 6 pregnancies in TESE cases [24%]

Thus confirming an azoospermic man can become a father of a child

Beneficial effect of cervical cerclage in preventing pregnancy loss

To find out results of cervical cerclage in patients with cervical incompetence [CI] for preventing pregnancy loss. Observational case series. Fatima Hospital Baqai Medical University Karachi, from January 2010 to December 2011. Patients with previous history of mid-trimester pregnancy loss, previous early preterm deliveries and cervical length < 2.5cms were included. McDonald cervical cerclage was placed around the cervix between 13-24weeks of gestation with silk no.2 after excluding intra-uterine infection, gross fetal anomaly and placental abruption. Cerclage was removed at 37 week of gestation. The patients and neonates were followed till one week post delivery. A total of 33 patients were included. Pregnancy prolongation with delivery at term occurred in 87.8% [through vaginal delivery in 87.7% and via cesarean section in four -12% cases]. Preterm delivery [9%], miscarriage [3%], live born babies [93.9%], fetal survival rate [87.8%], peri-natal death[6%], per-operative complications [12%], post-operative complications [18%] were other findings. Birth weight more than 2500gms was noted in 54.5%. Cervical cerclage has beneficial role in properly selected patients with sonographically short and incompetent cervix

Complete androgen insensitivity syndrome in AN X Y female

An 18 years old, unmarried girl, attending the Gynaecological outpatient department, with history of primary amenorrhea, presented an ultrasonography report which revealed absence of uterine contours in that patient. There was no history of cyclical pain. Patient had two step sisters, aged 13 and 10 [born of different father], out of whom the elder had started menstruating. On clinical examination, the height of the patient was 167.5 cm and she weighed 52 kg. She had welldeveloped breasts. Her pubic and axillary hairs were scanty. Patient was admitted for further investigations, which showed elevated serum gonadotrophins [FSH=21.9 miu/ml LH= 9:46 miu/ml] and testosterone levels [5.08 ng/ml]. The pelvic ultrasonography was repeated which showed absent uterus but gonads were present bilaterally. Barr bodies were absent on buccal smear examination and karyotyping revealed 46 XY chromosomes. Examination of the patient under anaesthesia was carried out which showed normal labia majora, minora and uretheral opening and a short vagina. Gonadectomy was performed and subjected to histopathological examination, histopathology report showed that the gonads were testicular tissue. Patient's postoperative period was uneventful. She was advised to use vaginal dilators to increase the length of vagina. Hormone replacement therapy was prescribed to prevent early osteoporosis. She attended OPD for regular follow-up, no complaint were reported by the patient during this period

Myasthenia gravis and pregnancy

A 33 years old multigravida lady presented at 8 weeks of gestation for booking, with a history of previous three caesarean sections. In 1995, her first pregnancy ended up in spontaneous abortion. The development of classical symptoms of MG during her second pregnancy and delayed recovery from nondepolarizing muscle relaxant [used for general anaesthesia] led to the suspicion of MG. The neonate also suffered from transient neonatal MG. Later on, she was investigated and found to have raised anticholinesterase receptor antibodies [117 nmol/L], cholinesterase level [4355 micro /L] and serum anti-DNA [3.9 I.V/ml]. Other antibodies including ANA, AMSA and AMA were negative. The treatment for MG started with an anti-cholinesterase agent in a dose of 60 mg daily. Thymectomy was carried out in 1998 for enlarged thymus gland and her symptoms further improved. Thereafter, the dose of anti-cholinesterase drug was reduced to half i.e., 30 mg daily during subsequent three pregnancies. The present pregnancy was supervised intensively by an obstetrician and neurologist. An elective C. section with bilateral tubal ligation was carried out on term under spinal anaesthesia. A male baby weighing 4 kg was delivered with an APGAR scores of eight at one minute and ten at five minutes. The patient continued her normal oral therapy before and after the operation. Her puerperium was uneventful

Eclampsia-the incidence, maternal, perinatal morbidity and mortality

The paper was designed to evaluate the incidence, maternal and perinatal morbidity and mortality of Eclampsia. This study includes thirty patients admitted from 1st January 1994 to 31 st December, 2003. The incidence of eclampsia was studied retrospectively. Record of all cases were available for the management, maternal and perinatal outcome. Epilepsy or other conclusive disorders were excluded. Incidence of eclampsia was 6.3 per 10,000 deliveries or 1: 132.8 deliveries [0.75%] in our study. Most of them were young, primigravida, unbooked, referred cases and belonged to low socioeconomic class. The age range was 15-40 years, with a peak incidence in the third decade. Gestational age was 28-40 weeks with mean of 36 weeks. Mean fit admission delivery interval, mean admission delivery was 8 and 4.8 hours respectively. Most commonly patients had intrapartum eclampsia. Mean systolic and diastolic blood pressure was 167.2 mm Hg and 108.2 mmHg. Magnesium sulphate was used in 30% and diazepam in the rest of the cases. Seizure control was excellent with magnesium sulphate. Side effects were minimal and consciousness was regained. Hydralazine was the drug of choice as an antihypertensive. The caesarean section was the common mode of delivery [56.6%]. 7tventy-seven patients were discharged in satisfactory position, one left against advice and two expired. The maternal mobidity was observed in 22 cases. This includes coagulation failure, abruptio placenta, HELLP syndrome pulmonary edema and post partum psychosis. Maternal mortality ratio was 0.50 and perinatal mortality ratio was 1.25. Eclampsia is a life threatening obstetric emergency. Meternal and perinatal morbidity and mortality is quite high. Prompt and urgent efforts are essential aiming to prevent, detect and manage eclampsia

Imperforate hymen

Imperforate hymen is a rare congenital anomaly of the vagina generally presented with symptoms in pubertal girls. A case of 13 year old girl with an imperforate hymen is reported here. She presented with cyclical lower abdominal pain and a suprapubic mass. Perineal examination is diagnostic and confirmed by ultrasound pelvis and abdomen. After reassurance and counselling a hymenectomy was performed. The prognosis is good with surgical intervention. A follow up of 4-6 weeks showed no recurrence

21 years statistic of perinatal mortality in a private hospital

21 years statistics of perinatal mortality at Baqai Medical College Hospital along with maternal and foetal factors are discussed. A comparison of booked and non-booked cases is also done. In conclusion some recommendations to reduce perinatal mortality in the community are suggested