Metabolic syndrome in patients with schizophrenia

OBJECTIVE: To determine frequency of metabolic syndrome in patients with Schizophrenia, in a tertiary care armed forces setup

STUDY DESIGN: Cross sectional study

PLACE AND DURATION: Department of Psychiatry, PNS SHIFA, Karachi from October 2009 to April 2010

MATERIALS AND METHODS: Fifty six patients with Schizophrenia reporting for management in PNS SHIFA were enrolled as subjects. Demographic variables and other confounding variables were recorded in a structured Performa, Blood Pressure [BP] and Waist Circumference [WC] were measured while Fasting Plasma Glucose [FPG], Triglycerides [TAG] and HDL-Cholesterol [HDL-C] levels were estimated by routine methods in laboratory with quality assurance

RESULTS: More than half i.e.30 [53.6%] of subjects had Metabolic Syndrome [MS] as per ATP IIIA criteria. Further 25% [n=14]of subjects were positive for two components of MS. Low HDL-C levels were most prevalent component followed by hyperglycaemia, hypertriglyceridemia and increased WC while hypertension was least common component

CONCLUSION: Metabolic Syndrome and its various components are frequently co morbidity in patients with Schizophrenia

Early pregnancy termination; Using tamoxifen and misoprostol

To determine the effectiveness and safety of elective termination of pregnancies from 56 days gestational age 2nd trimester in which ingestion of 20 mg tamoxifen for 4 days was followed by oral administration of 1 or 2 days of 800 micro g misoprostol. A clinical trial. Department of Obstetrics and Gynaecology, Nishtar Hospital, and Private setup, Multan. January 2009 to January 2010. A total of 50 patients were included in the trial on outdoor basis. Of the 17 subjects with a gestational age between 50 and 56 days. 15[88.2%] aborted their pregnancies. The mean duration of uterine bleeding in the group of women who aborted their pregnancies was 8.1 days with a range of 1-34 days. ln conclusion, the regimen of oral tamoxifen followed by oral administration of misoprostol was found to be an effective and rapid method to electively terminate early gestation of 8 weeks duration or less with no serious side effects.

role of metformin therapy in women with polycystic ovarian syndrome

To determine the efficacy of metformin therapy in women with PCOS in terms of ovulation induction and pregnancy. The study was carried out in Outpatient department Gynaecology Unit-1, Nishtar Hospital, Multan from January 2007 to March 2008. A total of 285 patients fulfilling the inclusion criteria [oligo/hypomenohorea, infertility, weight gain, hyperandrogenism] were enrolled. Ultrasound pelvis was obtained in all women. Presence of eight or more multiple follicles in one or both ovaries was the cut off number for positive ultrasound. Patients with other causes of infertility were excluded from the study. Metformin was adjusted to 500 mg thrice daily. Six months later patients were evaluated for response to metformin therapy. At the start of the study, 78% women had menstrual irregularity, 54% had primary and 46% had secondary, ultrasound features were found in 94% patients, hirstism in 70% and weight gain was found in 64% of patients. After six months of metformin therapy, ovulation was observed in 66% of women while 52% of patients conceived on metformin, therapy alone. Metformin alone was an effective treatment for PCOS in terms of ovulation induction and pregnancy

role of metformin therapy in women with polycystic ovarian syndrome

To determine the efficacy of metformin therapy in women with PCOS in terms of ovulation induction and pregnancy. The study was carried out in Outpatient department Gynaecology Unit-I, Nishtar Hospital, Multan from January 2007 to March 2008. A total of 285 patients fulfilling the inclusion criteria [oligo/hypomenohorea, infertility, weight gain, hyperandrogenism] were enrolled. Ultrasound pelvis was obtained in all women. Presence of eight or more multiple follicles in one or both ovaries was the cut off number for positive ultrasound. Patients with other causes of infertility were excluded from the study. Metformin was adjusted to 500 mg thrice daily. Six months later patients were evaluated for response to metformin therapy. At the start of the study, 78% women had menstrual irregularity, 54% had primary and 46% had secondary, ultrasound features were found in 94% patients, hirsutism in 70% and weight gain was found in 64% of patients. After six months of metformin therapy, ovulation was observed in 66% of women while 52% of patients conceived on metformin, therapy alone. Metformin alone was an effective treatment for PCOS in terms of ovulation induction and pregnancy

Fetomaternal outcome of cases referred to Nishtar Hospital, Multan

To determine feto-maternal outcome and to identify factors associated with adverse obstetric outcome. This descriptive case series study was conducted in the Department of Obstetrics and Gynecology Unit lit. Nishtar Hospital, Multan. During the period from 18[th] July 2007 to 17[th] January 2008. One hundred patients who were admitted through emergency after a trial of labour by traditional birth attendants [TBAs], lady health visitors [LHVs] or doctors at home or private clinics were managed and followed in the department of gynecology and obstetrics Unit-II. Mean age of the patients was 27.28 +/- 5.13 years. Fever was the most common complication found in 69[69%] patients. Antepartum hemorrhage occurred in 22 [22%] cases. Postpartum hemorrhage complicated 46 [46%] pregnancies leading, to shock in 51 [51%] patients. Oligohydramnios was observed in 35 [35%] patients and uterine rupture in 5[5%] cases. There were 3 [3%] maternal deaths. Low Apgar score was observed in 36 [36%] patients. Meconium staining was common in 34 [34%] cases and 34 [34%] patients needed for hospitalization. Fetal growth restriction was found in 23 [23%] patients. There were 23 [23%] fetal deaths. Postpartum hemorrhage led to maternal and fetal complications in majority of the patients which was not handled