Prevalence of allergic disease and related allergens in Pakistan in 2007

To identify the frequency of allergic diseases and the causative factors in patients of all the four provinces of Pakistan as well as from Rawalpindi and Islamabad. Secondary data for the year 2007 was analyzed. Skin prick was the method adopted for analyzing the response of the patients to allergies. The results were analyzed and it was found that allergic rhinitis [24.62%] and urticaria [24.04%] were the most common diseases. When city and province data was analyzed it was found that allergic rhinitis was the main allergic disease of Islamabad, NWFP [Khyber Pakhtunkhwa] and Sindh. Similarly urticaria was the commonest allergic disease of Rawalpindi and Baluchistan. Mixed cases of respiratory diseases were common in Punjab and NWFP [Khyber Pakhtunkhwa]. Pollen, dust and Paper mulberry were the main aero allergens involved in triggering the disease beside thresher and raw cotton allergens as detected through IgE mediated skin prick test. It is concluded that allergy presents with a wide variety of clinical manifestations. Allergic Rhinitis was the main disease but cases of bronchial asthma and mixed respiratory allergies were also not less. Urticaria was the main skin disease. Aeroallergens were the main causative or triggering factor for respiratory tract allergies and their role was also present in urticaria and eczema cases as compared to food allergens which were playing minimal role

Maternal mortality in a tertiary care hospital, Lahore: a four year review

This study was carried out to determine the cause and frequency of maternal deaths in Jinnah Hospital, Lahore which is a tertiary care hospital. The study was performed between January 2000 and December 2003 at Gynae unit-I. The case notes of all patients who died during January 2000 to December 2003 period in Jinnah Hospital gynecological unit-I as a result of conditions associated with pregnancy, labor, and puerperium [6 weeks after pregnancy] were reviewed in an effort to identify the most common cause of maternal deaths. Final conclusion regarding the causes of death were drawn after consultation within the department as well as with the concerned department like Medical, Surgical, Anaesthesia and ICU. Total number of deaths recorded during this period was 46. Maternal mortality ratio, measuring the risk of deaths specifically during pregnancy, was calculated to be 289.58/100,000 live births. Direct obstetrical deaths were 43 [93.47%] and there were three indirect deaths. Obstetrical hemorrhage accounted for 14 cases [30.43%]. Septicemia was second most common [11 cases, 23.91%]. Eclampsia accounted for 7 cases [15.21%]. Maternal mortality rate has been improved in 2002 [198.91/100,000] as compared to 333.55/100,000 in 2000 but again there was rise in 2003 [308.64/100,000]

B-Lynch suture for the management of post partum hemorrhage - a local experience

Objectives: To assess the efficacy of B-Lynch suture in the management of postpartum hemorrhage

Study Design: Case series report

Study Setting: Department of Obstetrics and Gynecology unit I, Jinnah Hospital, Lahore

Materials and Methods: The data was collected retrospectively from hospital record during July 2003 to June 2004, of patients with PPH in whom B-lynch suture was applied to control hemorrhage. The study included 45 women who were admitted through emergency or out patient department during last one-year period who fulfilled the inclusion criteria. Data was collected according to a pre-set proforma which included age, parity, gestational age, cause of PPH, estimated blood loss, number of transfusions needed and duration of hospital stay and was reviewed and evaluated in terms of treatment outcome, potential side effects and the efficacy of B-Lynch suturing technique as treatment of postpartum hemorrhage. Ratio and proportions were calculated and Chi- square test was used for significant associations

Results: The age of the patients ranged from 2035yrs and parity from 1-6. Gestational age was from 34-41wks. 36 [80%] women had PPH due to uterine atony, while 9 [20%] had PPH due to placental causes, and none of them had bleeding disorders. The estimated blood loss was 1000-1500cc in 15 patients [33.33%], 1500-2000cc in [62.22%] and 2 patients [4.44%] had blood loss more than 2000cc. 15 [33.33%] patients required 3 transfusions, 28 [62.2%] required 4 transfusions and only 2 [4.44%] women required 5 transfusions. Suturing technique has been applied successfully in 44/45 patients with failure rate of 2.22%

Conclusion: The B-Lynch suture is a valuable addition to the surgical treatment of postpartum hemorrhage because of its simplicity of application, relative safety, life saving potential and its capacity for preserving the uterus and thus fertility. Satisfactory haemostasis can be assessed immediately after application

Symptomatology of functional ovarian cysts

Objective: To study the symptomatology of functional ovarian cysts. Study Design: Cross-sectional, observational study. Setting: Outpatient Department of Gynae Unit, Jinnah Hospital, Lahore from June 2003 to December 2003

Material and Methods: All patients attending Gynae outpatient department Jinnah Hospital, Lahore who met the inclusion criteria were selected. Information regarding age, symptoms like abdominal pain, menstrual cycle pattern, dyspareunia, hirsuitism and obesity were documented

Results: During the six months period fifty-seven patients were included in the study, 38 patients [66.66%] of the study population was less than 30 Yrs of age, 26 patients [45.61%] had dysmenorrhoae, 14 patients [24.56%] had menorrhagia. No other menstrual irregularities were noted. 11 patients [19.29%] presented with lower abdominal pain. 27 patients [47.36%] had body mass index of greater than 30. Acne was seen in 20 [35.08%] patients and melasma in 12 [21.05%]. Family history of ovarian cysts was reported in 3 patients [5.26%] only

Conclusion: Functional Ovarian Cysts are often asymptomatic and seen in relatively younger age group [less than 30 years]. The results of this study reflected a positive association between functional ovarian cyst and obesity. Although dysmenorrhea was also seen in half of the patients of functional ovarian cysts, more studies with larger patients base are required to judge any association