Uterine rupture: an audit to analyze management options, maternal and fetal outcome

Study Design: An analysis of 14 cases of ruptured uterus was done during January 2003 to December 2003 in Obstetrics and Gynae Department of Lahore General Hospital, Lahore. The purpose of this Audit was to analyse the different management options, maternal and fetal outcome in uterine rupture. Material and Total no of births in 2003 was 4840. Total number of ruptured uterus found to be 14 [2.9%/1000] deliveries. Among these incomplete rupture were 3 [21.4%] and complete rupture were 11 [78.4%]. Regarding the common sites of uterine rupture lower uterine segment interior surface = 11 [78.4%]. Lower uterine segment posterior surface = 2 [14.2%] and upper uterine segment rupture was = 1 [7.14%]. The most common cause of uterine rupture was found to be multiparity and injudicious use of oxytocin by TBA in 5 cases. [35.7%] and previous uterine surgery in 5 cases [35.7%]. 2 cases [14.21] were due to cephalopelvic disproportion due to hydrocephalus and 2 [14.2%] cases were of malpresentation [transverse lie] mostly handled at home by TBAs. Hysterectomy, total or sub total was done in 7 cases [50%]. Repair of uterus was done in 5 cases [35.7%], in 2-cases [14.2%]. Bladder repair alongwith uterine repair was done. In two cases [14.2%] of scar dehiscence, repeat cesarean section was done. The maternal mortality was found to be zero, while intrauterine death were 10[71.4%] and alive babies were 4 [28.5%] high perinatal mortality of 71% were found. Ruptured uterus is avoidable catastrophe by proper education, training of patients and TBA's and by providing effective family planning services, transportation, diagnostic facilities and by reducing the unnecessary caesarean section

Salivary gland tumors - a three years experience at King Edward medical college, Lahore

Salivary gland tumours make an important part of oral and maxillofacial pathology. Only few studies have been done in Pakistani population. The aim of this study was to describe morphological types of salivary gland tumours diagnosed at King Edward Medical College/ Mayo Hospital, Lahore during the years 1999-2001 and to compare their demographic data with those previously published. Material and This descriptive cross-sectional study was carried out at King Edward Medical College/ Mayo Hospital, Lahore. It reports 117 cases of salivary gland tumours diagnosed at Pathology Department during 1999-2001. Of the 128 specimens of salivary glands, 117[91.4%] were confirmed as salivary neoplasms. Out of them, 62.7% were benign and 37.6% malignant and a slight female predominance [58.1%] was found. The most common location was the parotid gland [65.8%] followed by minor salivary glands [19.6%]. Majority oft he t tumours was diagnosed during 3rd to 5 decades of life. Median age for benign tumours was 33 years [range 1-78] and a female predominance [58.9%] was seen again. Median age for malignant neoplasms was 45 years [range 9-70] with a female predilection [56.8%]. However, 4 out o f 5 patients with Warthin's tumour were men. Pleomorphic adenoma was the most frequent tumour [51.3%], followed by mucoepidermoid carcinoma [25.6%], adenoid cystic carcinoma [7.7]], Warthin's tumour [4.3%] and monomorphic adenoma [2.6%]. Two cases each of oncytoma and adenocarcinoma were recorded. Rare categories [single case each] of salivary tumours included lipoma, acinic cell carcinoma, basal cell adenoma, capillary haemangioma, metastatic carcinoma and non Hodgkin's lymphoma. The principal site of salivary tumours was the parotid gland and females were most affected. Pleomorphic adenoma was the most frequent finding. The results of this study are comparable with other studies