Female sterilisation: a retrospective study

This is retrospective study of 2647 cases of female sterilisation carried out at Holy Family Hospital, Rawalpindi from March 1991 to January 1994. Most of these were interval sterilisations done on outpatient basis. Others were postpartum sterilisations before discharge, and tubal ligations carried out during caesarean section. There was no mortality associated with these sterilisations, and the morbidity was also minimal with only 7 major complications. 45 patients experienced minor complications. Modified Pomeroy's method of tubal ligation carried out in the form of minilaparotomy remains an effective, safe and economical method of female sterillisation

Pregnancy complicated with diabetes: a one year experience

A total of 30 women with abnormalities of glucose tolerance were studied and followed up at Holy Family Hospital from November 1992 to October 1993. There were 21 insulin treated pregnancies of whom 13 were insulin dependent diabetics prior to the pregnancy. The remaining 7 pregnancies occurred in women who were diagnosed as gestational diabetics during the pregnancy and were treated with insulin because of persistent preprandial blood glucose concentrations in excess of 6 mmol/1 despite dietary advice. One patient who had impaired glucose tolerance also required insulin. Of the remaining 9 who were euglycemic oil diet alone, 4 had impaired glucose tolerance and 5 had gestational diabetes as diagnosed by 75 gm glucose tolerance test [WHO Criteria]. All but 2 pregnancies progressed to term and none were allowed to go beyond 40 weeks. Spontaneous labour was attained in 56.6% of all cases and in 23.3% labour was induced mostly because the patients had completed 40 weeks of gestation. Our caesarean section rate was 43% which compares favourably with international figures. There was one still birth and one neonatal death Perinatal mortality adjusted for lethal congenital anomaly, was 3.3% which compares favorably to 5% rate for most recent series. Our data suggests that strict diabetic control has resulted in a dramatic fall in perinatal mortality in diabetic pregnancies and that this allows a majority of these women to go past 38 weeks of pregnancy, hence allowing spontaneous labours with an increased chance of vaginal delivery

Use of tamoxifen in male infertility

This is a prospective study of use of tamoxifen in 119 cases of male infertility. The drug was used when no hormonal or other cause for sub fertility was found. All patients had treatment for at least three months. 43% of the cases registered an improvement greater then 20%from the basal figures in one or both of the seminal parameters. 15 pregnancies were reported in the group of patients completing at least three months of treatment