Accuracy of sonographic features to diagnose malignancy in ovarian cycsts- in a tertiary care hospital Bahawalpur- Pakistan

Ovarian mass is a common clinical problem in reproductive age women, and ovarian malignancy presents late and thus at an advanced stage. That is the reason for its poor 5 year survival despite all advances in gynaecological surgery and oncological chemotherapeutics. It is extremely essential to estimate the risk of malignancy before deciding on the type of surgery for a patient with an ovarian cyst or mass. Objective was determine the sensitivity and specificity of individual sonographic features to predict malignancy in ovarian tumours. It was a cross - sectional study. Clinical and sonographic evaluation of 220 patients presenting with ovarian cysts to Department of Gynaecology, Bahawal Victoria Hospital Bahawalpur was followed by histological examination at Department of Pathology, Quaid-e-Azam Medical College Bahawalpur. We analysed 220 cases of ovarian masses. Mean age of patients was 47.3 +/- 3.8 years. Most common [57.3%] presenting complaint among these patients was abdominal pain followed by distension and palpable mass [21.8% and 19.1% respectively]. On ultrasonography, ecogenicity, papillary projections and multilocularity were commonly observed in malignant cases. Colour Doppler was used to estimate the blood flow. On histopathology, 207 [94.1%] were diagnosed as benign and only 13 [5.9%] as malignant. Among benign, most common diagnoses were follicular / luteal cysts [34.8%] followed by serous cystadenoma [24.6%] and serous cysts [15.4%]. Among malignant, 6 [46.2%] were serous cystadenocarcinoma, 3 [23.1%] were mucinous adenocarcinoma and 2 [15.4%] were granulose cell tumor. Most of ovarian masses are diagnosed as benign. Sonographic features especially increased ecogenicity, solid component, papillary projections, multilocularity and increased blood flow do predict malignant behavior but their sensitivity is low

Gestational diabetes mellitus and obesity: an experience at a teaching hospital in Bahawalpur, Pakistan

To compare the frequency of gestational diabetes mellitus in second and third trimester in obese and non-obese women. It was a prospective study conducted at Department of Obstetrics and Gynaecology, Bahawal Victoria Hospital Bahawalpur. Sixty two obese and 62 non-obese women having singleton pregnancy were included in the study at their booking visit at tilde 14-20 weeks of gestation. Women having family history of obesity and chronic ailments and those with age >35 or parity > 5 were excluded. Mean age was 28.12 +/- 2.72 years among the group of obese women as compared to 27.89 +/- 2.34 years in non-obese group. Commonest parity among the obese women was 3-4 [n=31, 50%] compared to 46.8 % [n=29] in non-obese group. Development of gestational diabetes mellitus was 22.58% [n=14] in obese group which was significantly higher than 6.45% [n=4] in non-obese group [p=0.001]. Gestational diabetes mellitus developed in significantly higher number of obese women as compared to non-obese women

Malignant and benign lesions of female genital tract - an experience at a tertiary care hospital in Bahawalpur - Pakistan

Frequencies and incidence rates of site - specific cancer and other pathological lesions are reported regularly in different studies, but mostly not by the histological type within site. This study reviews 3 years data of female genital tract tumours from 2008 - 2011, at Quaid-e- Azam Medical College / Victoria Hospital, Bahawalpur. Data of the surgical specimens of uterus, ovary, vulva, vagina and cervix submitted to the Department of Pathology was reviewed and analysed for the type of specimen, tissue of origin, different diagnosed histological types and finally the behaviour of tumour i.e. benign or malignant. A total of 1373 surgical specimens of female genital tract were submitted in 3 years, out of which 101 [7.4%] were malignant. Twenty nine percent and 28% of the neoplasms were from cervix and vagina respectively followed by vulva [17%], and then ovary and uterus [12% each]. Squamous cell carcinoma was the most common invasive malignancy of the cervix [86%], vulva [77%], and vagina [71%]. Adenocarcinoma was the most frequent malignancy in the uterus [53%] and ovary [61%]. The 73% of the burden of benign disease was contributed by uterine lesions, 3/4th of them being leiomyoma and endometrial hyperplasia. Squamous cell carcinoma was the most frequent malignant tumour of the cervix, vagina and vulva. Adenocarcinoma was the most common malignancy in ovary and uterine corpus. Epidemiologic studies may provide more definite information by considering the effect of these subtypes in examining risk factors

Efficacy and complications of prostaglandin F2 a [alpha] for second trimester pregnancy termination in primigravida vs multigravida

To compare the efficacy and complications of extraamniotic instillation of Prostaglandin F2 Alpha [PGF 2alpha] [Pharmacia] via a Foley's catheter for second trimester pregnancy termination among primigravida and multigravida. It was a prospective study conducted at Department of Obstetrics and Gynecology, Bahawal Victoria Hospital, Bahawalpur. The study was done in the period from June 2008 to February 2009. One hundred pregnant women at 14-24 weeks of gestation divided into two groups viz. Group 1: Primigravida and Group 2: Multigravida. The mean age of primigravida was 23.12 years as compared to that [27.97 years] of multigravida. The mean gestational age was comparable in both groups. The mean induction expulsion interval found in primigravida was 16.90 hours and in multigravida .10.13 hours. The complications like dead fetus, pelvic infection, coagulopathy, rupture, incomplete abortion were less among multigravida as compared to primigravida. Our study concludes that Use of PGF 2alpha for second trimester pregnancy termination is cost effective and safe way among primigravida and multigravida. The complications like pelvic infection are less common among the multigravida

Efficacy and Complication of misoprostal for second tremester pregnancy termination among primigravida versus multigravida

To compare the efficacy and complications of Misoprostol for Second Trimester Pregnancy termination among primigravida and multigravida. It was a prospective study conducted at Department of Obstetrics and Gynaecology, Bahawal Victoria Hospital, Bahawalpur. The study was done in the period from June 2008 to February 2009. One hundred and twenty pregnant women at 14-24 weeks of gestation divided into two groups viz. Group 1: Primigravida and group 2: Multigravida. Patients needing terminations of pregnancy were 10%. The data was collected on a specially designed proforma. It was analyze on SPSS version 13.0.0. Chi-square test was applied to determine the statistical significance. The mean age of primigravida was 22.57 years as compared to that [27.37 years] of multigravida. The mean gestational age was comparable in both groups. The mean induction expulsion interval found in primigravida was 15.59 hours and in multigravida 9.13 hours. The complications like dead fetus, pelvic infection, coagulopathy, rupture, incomplete abortion were less among multigravida as compared to primigravida. Our study concludes that use of Misoprostal for second trimester pregnancy termination is cost effective and easy to administer among primigravida and multigravida. The complications like pelvic infection are less common among the multigravida

To compare the efficacy and complications of misoprostal and prostaglandin F[2] alpha for second trimester pregnancy termination

To compare the efficacy and complications of Misoprostal and Prostaglandin F[2] alpha for Second Trimester Pregnancy termination. Sixty pregnancy women at 14-24 weeks of gestation divided into two group A and B. Group-A Misoprostal, Group-B Prostaglandin F[2]alpha. Patients needing terminations of pregnancy were 10%. The mean induction expulsion interval found in Group-A 19.13 hours and in Group-B 20.07 hours. The complication in Misoprostal group like dead fetus, pelvic infection, coagulopathy, rupture, incomplete abortion were less as compare to PGF[2] alpha group. Misoprostal is more effective then PGF[2] alpha for second trimester pregnancy terminations