Maternal mortality: a 10-year study at Nishtar-Hospital Multan

To analyse causes of maternal deaths and to identify preventable causes leading to this tragedy in our setup. An analytical, hospital-based study. Department of Obstetric and Gynaecology, Nishter Hospital Multan from June-August 2005. During the study period retrospective data was collected for period of 10 year from January 1995 to December 2004. This data was analyzed in order to determine the Maternal Mortality Rate [MMR], causes of death and characteristics of the mothers who died including her age, parity and whether they were booked or unbooked. A total numbers of 30031 deliveries took place during the study period and there were 178 maternal deaths with maternal mortality rate of 593/100,000 LB [live births]. 7[3.9%] patients were below the age of 20, 74[41.5%] were in the age group of 21-30 and 82[46%] in 31-40 years age range. 15[8.42%] were above the age of 40. Most of them [69%] were grand multiparas [Parity >5]. The major causative factors were haemorrhage 63[35.4%], eclampsia 41[23.03%], sepsis 25[14.04%], anaemia 18[10.1%], hepatic encephalopathy 14[7.9%], abortion 11[6.2%]. Majority of the patients were unbooked and presented in the hospital very late. A high proportion of potentially preventable maternal deaths indicate the need for improvements in education for both patient and health care provider. The provision of skilled care and timely management of complications can lower maternal mortality in our setup

Occupational asthma and irritant symptoms among endoscopy nurses exposed to glutaraldehyde

This cross-sectional study was done to investigate the nature and prevalence of respiratory and irritant symptoms experienced by a sample of hospital endoscopy nurses exposed to glutaraldehyde [GA] and whether they develop occupational asthma under current working conditions in endoscopy units. It included 30 exposed endoscopy nurses and 30 nurses not exposed to GA as a control group. The results showed a high prevalence of lower respiratory tract [L.R.T.] symptoms followed by work related symptoms [WRS's] of dermatitis then WRS's of nasal and eye irritation. Also, there were significant differences between both groups as regards these symptoms. There were significant differences between exposed and non-exposed groups in the mean values of FVC%P., FEV1%P and FEF25-75%P. Moreover, the ventilatory function parameters among the exposed group, were significantly lower in workers complaining from WRS's of L.R.T. Also, negative correlation was found between the duration of exposure and the ventilatory function parameters. Occupational peak flow diaries completed by exposed workers with WRS's of the L.R.T. showed six cases of bronchial asthma [20%]. There was no significant difference between exposed and non-exposed groups as regards non-specific IgE. Thus, it was obvious from this study that GA induces irritant effect on the upper and lower respiratory tract, skin and eyes. Also, it confirms that GA asthma does exist

Respiratory and dermatological hazards among workers in textile dyeing

This study was done to find out the prevalence of respiratory and dermatological disorders among workers exposed to textile dyes and to investigate the dyes most probably associated with respiratory and dermatological disorders among exposed workers. It was carried out on 200 workers in dye houses in the textile dyeing industry in Al-Mahalla Al-Koubra as a study group and 200 workers not exposed to dyes as a control group. The results of this study revealed that: there was no statistically significant difference between both groups as regards age. marital status, residence, social class and educational level. The prevalence of smoking in both groups was almost the same with no significant difference. Inquiry about chronic cough, chronic phlegm and chronic bronchitis showed high prevalence rates in both groups but there were no significant differences between them. On the other hand, chest tightness, dyspnea, asthma and conjunctivitis were found to be significantly higher among the exposed group than among the non exposed group. In the present work, the longer duration of work exposure was found to be related to higher prevalence rate of respiratory and irritant symptoms, the difference between the groups was significant. Regarding the relationship between smoking habit and the prevalence rate of chronic respiratory symptoms, the current study demonstrated that there was significant difference between the three groups of exposed workers [smokers, non- smokers, ex-smokers], as regards chronic cough, chronic phlegm, chronic bronchitis and asthma. On studying the ventilatory functions, significant differences between exposed and non exposed groups of workers were found in the mean values of FVC% predicted, FEV1% predicted. FEV1/FVC% and FEF 25-75% predicted. Further more, these parameters were significantly lower among smokers and when the duration of dye exposure was prolonged. Multiple regression analysis was done to prioritize the factors affecting the ventilatory function parameters among the exposed workers and it revealed that, although the exposure to dye had a powerfull effect, yet smoking [number of cigarettes smoked per day and duration of smoking] had the strongest effect. Eczema was observed among 10% of the exposed group, while no cases of eczema were detected among the control group. About 86% [18 workers] of the workers having eczema gave positive reactions to the dye allergens. The prevalence of positive patch test reaction was found to be higher to disperse dye than to the reactive dye in the current study. This study proves that textile dyeing workers suffer from high prevalence of respiratory and dermatological disorders and the prevalence of positive patch test reaction was found to be higher to disperse dye than to the reactive dye

Selenium deficiency and ovarian tumors

The objective of this study was to investigate a possible link between selenium deficiency and problems of ovarian tumors aiming to understand the nutritional status and solve some of the health problems. Serum selenium levels were measured in 60 Egyptian women divided into two groups. Selenium levels in women of group II showed significantly lower values than women of group I. A significant decrease was found in women of group II than the other studied women

Effect of passive smoking on thyroid function in neonates

To evaluate the effect of passive smoking on thyroid function in infants. Cord serum Tri-iodothyronine [T3], Thyroxine [T4], Serum thyroid stimulating hormone [TSH], Thyroglobulin [Tg], and cord plasma thiocyanate [SCN] were measured at birth in 43 infants born to smoking fathers, and in 40 infants whose both parents were non-smokers. No significant differences were observed in cord serum concentrations of T3, T4 and TSH among the two groups. Tg and SCN concentrations were significantly higher in the study group than in controls [p<0.0001]. T3, T4, TSH were not correlated with SCN values, while there was strong [+ve] correlation between Tg and SCN [r=0.97]. Birth weight was significantly higher in controls than in the study group and, by regression, it was affected mainly by gestational age, and was not affected by SCN. Passive smoking during pregnancy may be responsible for elevated serum levels of thyroglobulin due to a direct effect of thiocyanate on the thyroid gland

Diagnostic cardiac catheterization in and outpatient setting: the khamis experience

Diagnostic cardiac catheterization as a daycase procedure is now being practiced widely in the Western world. A successful daycase cardiac catheterization program is generally convenient to the patient, reduces the cost of the procedure, and allows optimal utilization of services provided by the cardiology department. This study presents the results of diagnostic cardiac catheterization in an outpatient setting in our hospital over a one-year period. The study shows that with multidisciplinary approach involving strict criteria for patient selection and proper patient education, diagnostic cardiac catheterization can be performed safely in an outpatient setting in Saudi Arabia