Hearing impairment after acute bacterial meningitis in children

Objective: To determine the incidence of hearing loss after acute episode of meningitis in children

Methods: A descriptive study carried out in the Department of Pediatric Medicine of The Children's Hospital Lahore, Pakistan from January 2014 to July 2016. A total of 175 children one month to 13 years of age admitted with diagnosis of meningitis were included. Complete blood count, CSF cytology, biochemistry and culture sensitivity were sent. CT scan brain was done if required. Hearing assessment was done two weeks after admission using otoacoustic emissions in the patients having normal tympanogram. Hearing impairment was classified as sensorineural if otoacoustic emissions were absent while tympanometry was normal

Results: Of 175 children, 58% were males and 42% were females. Mean age was 2.1 years. Orientation as assessed by Glasgow comma scale [GCS] was normal in 63% while 5% had GCS<8 and 32% had GCS between 8 and 15. Signs of meningeal irritation were seen in 58% while focal signs only in 4%. In 15 % cases CT scan was done, out of which 73% showed abnormal findings. Otoacoustic emissions were absent in 22% of cases. Risk factors of hearing deficit were stay duration of more than 10 days [p=0.04], low GCS at presentation [p=0.009] and meningitis with complications [p=0.008]

Conclusion: The frequency of hearing loss is 22% following acute episode of meningitis which necessitates the need for implementation of screening assessment after meningitis in Pakistan. Prolonged stay, low GCS and complicated meningitis are risk factors for hearing impairment

Surgical management of postpartum and pelvic haemorrhage

Despite the ready availability of banked blood and blood products, postpartum and pelvic haemorrhage remains one of he major causes of mortality and morbidity all over the world. In developing countries, as in Pakistan, it is among the first three causes of maternal mortality. Sixty one cases were included in this study over a period of nine years from various hospitals, such as 1. Maternity and Children Hospital, Dammam [Saudi Arabia] Affiliated with King Faisal University Al-Khobar [Saudi Arabia]. 2. Services Hospital, Lahore. Affiliated with Allama Iqbal Medical College, Lahore [Pakistan]. 3. Bahawal Victoria Hospital, Bahawalpur. Affiliated with Quaid-e-Azam Medical College, Bahawalpur [Pakistan]. Our management mainly based on surgical treatment alongwith conventional therapy

comparative study of vaginal prostaglandin E2 pessaries with intravenous oxytocin for the induction of labour after spontaneous rupture of membranes

In a prospective randomized study, 60 patients were induced with 3 mg vaginal FE2 pesseries or intravenous oxytocin. Oxytocin stimulation was associated with shorter labour and a lower incidence of abnormal cervimeteric progress, after spontaneous rupture of membranes. Out of these patients given PGE2 20% required a second dose after four hours of slow progress. 10% of primigravida subsequently developed abnormal labour and required augumentation by oxytocin to correct their uterine contractions. Two caesarian sections were carried out for disproportion and remaining 58 patients were delivered vaginally. PGE2 pesseries were not associated with an increased incidence of hyperstimulation or sepsis. In conclusion oxytocin infusion is a safe, effective but inconvenient method of induction of labour, while PGE2 pesseries are safe, effective, more acceptable but an expensive method of induction of labour

Study of 780 cases of infertility

Inspite of world population explosion, the desire for reproduction remains a basic human desire. Infertility is a complex phenomenan, and couples confronted with this problem, need a lot of emotional and psychological support besides intensive and prolonged investigations and treatment. Overall incidence of infertility varies from 15 to 20% all over the world. Etiological variation from one country to another is due to their differences in social background. A study of 780 cases of infertility have been carried out, to ascertain the cause of infertility. These patients range from 18 to 40 years of age, and come from various social groups. After initial investigations, they were divided into four groups, depending upon the etiological factor. It is observed that conception rate varied from one group to the other. Overall conception rate achieved was 44.743% which is reasonably encouraging with our present management