Anxiety and depression in pregnant women presenting in the OPD of a teaching hospital

Recent research has shown that psychiatric disorders are more common during pregnancy. This study was done to investigate the prevalence of anxiety and depression during pregnancy in females presenting in the antenatal clinic. The study also tried to find out risk factors associated with anxiety and depression in pregnancy in the above-mentioned population. Design: This was a descriptive survey of 200 outpatients. Place and duration of study: This study was done in the outpatient's department of Lady Atchison Hospital, Lahore. The study was done from May 2001 to October 2001. Study sample consisted of 200 consecutive outpatients presenting in the antenatal clinic. Pregnant women who agreed to be interviewed were included in the study. Demographic details were noted. PSE was used as an interviewing instrument and ICD-10 was used as diagnostic criteria. According to ICD-10 diagnostic criteria 34.5% of females were suffering from anxiety and 25% were suffering from depression. Young age, loss of parent during childhood, past history of psychiatric illness, family history of psychiatric illness was identified as possible risk factors to develop anxiety and depression during pregnancy. Prevalence of anxiety and depression was similar to many studies reported from the West. Pregnant females with possible risk factors should be specially screened for anxiety and depression. Locally prepared and validated instruments need to be developed for use in Pakistan

Acute renal failure: analysis of aetiological factors and outcome

To analyse the causes of acute renal failure [ARF] and management and outcome in these cases. All patients with ARF coming to SlUT between January 1990 and December 1998 were studied. A total of 1716 ARF cases were seen. Of these 43% had medica1, 28%surgical and 17% obstetrical causes. Haemodialysis was required in 88% of patients. Overall mortality was 18%. Causes of ARF in this part of the world is different from the western world. Preventable causes e.g. gastroenteritis, obstetrical haemorrhages, torture induced rhabdomyolysis and malaria, contribute to large percentage of the ARF population

population genetic study of southern Sindh [Hyderabad and Jamshoro] Pakistan: Distribution of ABO and Rh blood alleles

A Sample of 38360 human individuals from population of Hyderabad and Jamshoro yield allelic frequencies of 0.1157 +/- 0.00246, 0.1397 +/- 0.00254 and 0.7479 +/- 0.00150, for A[p], B[q] and O[r] alleles, respectively and 0.2209 +/- 0.0088 for d allele. The data suggests that no significant difference between sexes and study years in the distribution of allelic frequencies. The Jamshoro population runs close to Sindhi, Baloachi, Siraiki, Punjabi and Urdu speaking groups of Hyderabad population, explained on similarly of genetic composition of these populations

Citalopram in depressive disorders

Citalopram is a bicyclic phthaline and one of the newer Serotonin Specific Reuptake Inhibitors [SSRI] now available in Pakistan. A four weeks, open, clinical trial was carried out on 36 moderate to severely depressed patients to determine the efficacy and tolerability of this newer antidepressant. Twenty six% of patents showed improvement on Hamilton Rating Scale for Depression [HAMD] in the first week and fifty eight% at the end of four weeks [P<0 001] On CGI twenty eight% improved at the end of the study [P<0.001]. Sixty eight% of patients having suicide tendencies showed significant improvement. No significant changes in the ECG were recorded. No significant decrease in heart rate or drop in blood pressure was noted.The side effects were very few as the drug did not cause distressing anticholinergic effects or weight gain. This study supports the efficacy of citalopram for treatment of patients with moderate to severe depression However higher cost of the drug may restrict Its use for some of our patients

Patterns of drug abuse in patients at UN/PAK model drug abuse treatment centre

The present study describes basic data about the extent and varieties of drug abuse problem, in cases registered at UN/PAK Model Drug Abuse Treatment centre at Sir Ganga Ram Hospital Lahore. Total number of cases presenting to the centre through Psychiatric OPD from October 1988 May 1997 was nine hundred and thirty six. Out of them 319 cases sought in-patient care for detoxification. Among admitted case, 247 had a new admission while 72 sought readmissions. Majority of the admitted cases presented with the problem of Heroin and poly drug abuse The findings would be discussed in terms of sociological perspectives and the lessons to be learnt from the experience of this centre

Future of cervical screening programme in Pakistan: a two years experience of colposcopy at district headquarters hospital, Rawalpindi

Cervical cytology and colposcopic assessment of the same patients was carried out in Gynaecology Outpatient Clinic. Subjective selection of 250 adult females, presenting with vaginal discharge, postcoital intermenstrual bleeding, backache and cervical eclopy was done.Fiftv patients [20%] were dropped out clue to non compliance. One hundred and eight, two [91%] women were below the age of 40 years and eighteen females [9%] were above 41 yeas. Cervical cytology was normal in 75% samples. Eight% were showing cervical intraepithelial neoplasia WIN, I, II]. Seventeen% were having inflamatory iy changes.On colposcopy 20% cases showed abnormalities as aceto-white epithelium scluamous melaplasia orabnormal vascularpattern. Cervical polbp were seen in 8% women, colposcopically guided cervical punch biopsy in 18% patients showed inflamatory changes.Use of colposcope for the evaluation of gynaecological problems is indisposible in clinical practice. An awareness of population about the carcinoma cervix and collaboration among clinicians, cytologists and colposcopists is essential for prevention of carcinoma cervix

Prevalence of vaginal candidiasis in gynecology

Clinical presentation of patients reporting with vaginal discharge in Gynaecology Outpatient Department of Holv Familv Hospital, Rawalpindi and Women clinic and Fertility Advisors Centre, Islamabad was observed from December 199.3 to November 1994. Mean age was 30 years [range 19-60 year]. Candida albicans was positive in 48% and negative in 52% patients. Among Candida albicans negative patients, 18% had bacterial infection, 61% had no growth in culture media but pus cells were present in the smear; normal flora was found in 13% while 6% should Trichomonas vaginals. Main symptoms were vaginal discharge, pruritus, burning, soreness and pain. Excoriation, erythema and vaginal discharge was seen in almost every patient. Patients can be easily cured if early diagnosis of candidiasis is made

Ovarian tumours with pregnancy: 8 years experience

Clinical and pathological features of 9 ovarian tumours with pregnancy observed from 1988 to 1995 in District Headquarters Hospital Rawalpindi are discussed. Incidence of tumours was 1:2148.Age of patients ranged from 17-30 years [Mean 24 years]. Mostly tumours were on left side while 14% had bilateral tumours. Size of tumours varied from 8 to 15 cm [Mean 10.8 cm]. No malignant from 8 to 15 cm [Mean 10.8 cm]. No malignant cysts. Line of treatment depends upon the age of gestation period. Laparotomy is mandatory if complications occurs during pregnancy