RESUMO
The present study was aimed to evaluate the effect of educational intervention provided to the patients of hypertension through pharmacist with the goal to improve knowledge about hypertension, adherence to prescribed medicines, blood pressure control and HRQoL [Health Related Quality of Life]. A total of 384 patients were assigned randomly into 2 groups including intervention and control groups each having 192 patients. Urdu versions of knowledge questionnaire regarding hypertension, medication adherence scale [MMAS-U] by Morisky and EuroQol scale [EQ-5D] were utilized. Each patient's blood pressure was measured. After educational intervention, an increase was found in mean knowledge score about hypertension [18.18 +/- 4.00], adherence score [5.89 +/- 1.90], HRQoL score [0.73 +/- 0.12] and Visual Analogue Scale [VAS] score [69.39 +/- 5.90] among the IG. The blood pressure control also improved and lower systolic [131.81 +/- 10.98 mmHg] and diastolic blood pressures [83.75 +/- 6.21 mmHg] were observed among the patients of IG. This study showed that educational programs are useful for patients in increasing patient's levels of knowledge about hypertension, improving adherence to prescribed medication and enhancing blood pressure control. This increase is in turn accountable to improve HRQoL
RESUMO
Anovulatory infertility is prmmt in 75% of patients with polycystic ovarian syndrome [PCOS], in addition to oligomenorrhoea and signs and symptoms of hyperandrogenism. This study was performed to find the role oflaparoseopic ovarian drilling [LOD] in correcting anovulation, menstrual irregularities and failure of conception. Possible role of the factors as the predictors of success was also studied. This prospective cohort study included 49 women who were diagnosed with PCOS and anovulatory infertility. These patients had already tried various ovulation induction drugs for conception, and underwent LOD between January i, 2006 untill December 31, 2008 in the Department of Gynaecology and Obstetrics, at the Tertiary Care Hospital, Lahore. The major outcome measures spontaneous ovulation, menstrual regularity after LOD and influence of various pre-operative characteristics on pregnancy rates. Among 49 patients 33 [67.3%] started to menstruate regularly and ovulated spontaneously in 59.2%, of them 23 [46.9%] conceived. Younger age [less than 25 years], duration and infertility less than 5 years and higher LH [more than 12 lU/lit] emerged as clinically significant factors to have impact on successful outcome. BMI > 27 Kg / m[2], cycle pattern, morphology of ovary, LH / FSH ratios did not manifest significant role. Women with PCOS respond favour ably to LOD
RESUMO
In female reproductive tract the differential diagnosis of pelvic mass is quite variable because abnormality may arise from gynaecological or non gynaecological origin. The present study was designed to evaluate the efficacy of clinical examination and abdomino-pelvic ultrasonography and find out the frequency of malignancy in patients diagnosed with pelvic mass. It was a cross sectional prospective study of one year duration. Cohort study design on 107 patients with complaints suggestive of pelvic mass underwent clinical examination including history, abdomino-pelvic examination followed by abdominal ultrasound were evaluated. Only the patients who underwent laparoscopy or laparotomy were included in the study. Final diagnosis was correlated with histopathological diagnosis. Overall sensitivity of clinical evaluation was 50% while ultrasound was 80% sensitive in diagnosing the type of pelvic mass. Positive predictive value of clinical examination 71.4% was higher than ultrasound 66.6%. Frequency of gynaecological malignancy was 84%, while 1.9% malignancies were of non gynaecological origin. Our study has supported the view that clinical evaluation and ultrasound are initial modalities and to increase the sensitivity for definitive diagnosis other imaging facilities and tumor marker are needed