To compare the safety and efficacy of manual vacuum aspiration with misoprostol [ST mom] 600mg in incomplete miscarriage

OBJECTIVE: To compare the efficacy and safety of manual vacuum aspiration, and oral misoprostol in incomplete miscarriage

STUDY DESIGN: Comparative randomized controlled trial study

STUDY SETTING: Department of Obstetrics and Gynaecology [Unit-II] Liaquat University Hospital Hyderabad, Sindh from May 2011 to April 2012

MATERIAL AND METHOD: All eligible women who full filled the inclusion criteria were included in study after taking written informed consent. A total 222 women were included in study

In each group 111 were randomized either with 600 microgram ST mom or suction evacuation by MVA. Sample was randomized using computer generated random sequence. Opaque sealed study envelop were used for allocation. Primary outcome measure was to assess the efficacy of method in form of complete evacuation. Secondary outcome measure was occurrence of complication

RESULTS: 111 patients were randomized in each group. Mean age [years], parity and gestational age of study population were 28.4+/- 5.2, 3+/- 2 and 8.9+/- 12. Three patients in misoprostol [ST mom] group complain of pain while in MVA group none of patient complain of pain. So for safety is concern MVA is safer than misoprostol [p-value less than 0.031]

CONCLUSION: Both MVA and misoprostol can be used, as an effective method of uterine evacuation in incomplete abortion of < 12 weeks. MVA is significantly safer than misoprostol in terms of side effects

Frequency, knowledge and practice of tobacco smoking in pregnant women at outpatient department of a tertiary care hospital

Objective: to determine frequency, knowledge, and practice of tobacco smoking in pregnant women visiting outpatient department of Liquate University Hospital Hyderabad

Study design: descriptive observational study

Subjects and methods: study carried out at Liquate University Hospital Hyderabad from 1[st] Dec 2009 to 31[st] Jan 2010. All pregnant ladies visited the outpatient department of Obstetrics and Gynecology for antenatal care with an age range 18-46 years were enrolled for study. Semi structured questionnaire consisting various items used to explore the range of knowledge and practice of pregnant women as far as tobacco smoking is concerned. Data was analyzed using SPSS version 16.0

Results: a total of 350 pregnant women were included in this study. Frequency of tobacco smoking was 60.57% [212]. 179[51.14%] women were also using smokeless tobacco along with smoking. Only 42 [12%] knew hazards of tobacco consumption .Knowledge was high in 27 [7.71%] patients. Peer pressure was the reason for commencement of smoking in 234[66.85%] of women and depression in 60[17.14%]

Conclusion: tobacco consumption is a major health problem in pregnant woman. Obstetrician should promote smoking cessation during pregnancy using evidence based methods

Biofilms: microbes and disease: [review]

Bacteria that attach to surface aggregate in a hydrated polymeric matrix of their own synthesis to form biofilms. These represent microbial societies with their own defense and communication system. Transitioning from acute to chronic infection is frequently associated with biofilm formation.Bacteria in biofilms are innately more resistant to antimicrobial agents. The presence of indwelling medical devices increases the risk for biofilm formation and subsequent infection. The current antibiotic therapies are of limited effectiveness in resolving biofilms infection.This review attempts to discuss the stages in biofilm formation, their pathogenic mechanisms, effect of antimicrobial agents, detection and eradication of the biofilms.