Eclamptic patients; effects of magnesium sulphate as anti convulsant on maternal conditions

Objective: To compare the frequency of fits in the eclamptic patients before and after use of magnesium sulphate as anticonvulsant and enlist the complications of MgSo4

Subjects and methods: All the patients with more than 20 weeks, of gestational age, with any parity were includes in the study. Patients developed fits before giving magnesium sulphate and after were evaluated, all the patients were monitored for occurrence of complications due to drug. Magnesium sulphate administered for 24 hours after last fit of delivery and patient's blood pressure, pulse, respiratory rate tendon reflexes and urine output was monitored half hourly

Results: Mostly fits were noted in the patients before the treatment of magnesium sulphate and 1 to 3 fits were noted in the 57.1% of the cases, 28.5% patients were seen with 4 to 6 numbers of the fits while more than 6 fits were noted in the 14.2% of the cases, and after the treatment [use of magnesium sulphate] 1 to 3 fits were seen in the 5.7% of the cases, 4 to 6 fits were only in the 2.8% of the cases while no any patient was noted with above 6 fits. Proteinuria was present in the 80% of the cases and edema was found in the 42% of the patients

Conclusions: In the conclusion of our study MgSO4 found to be very effective and cheap for control of fits and has lower risk of recurrent convulsion

Effect of mother-infant early skin-to-skin contact on breastfeeding status: a randomized controlled trial

To evaluate the effect of mother-infant early skin-to-skin contact on breastfeeding behavior of infants. A randomized controlled trial. The study was conducted in the Department of Obstetrics of Pakistan Institute of Medical Sciences, Islamabad, from November to December 2009. Eligible mothers were assessed for the successful breastfeeding by using IBFAT tool. The time to initiate the first feed, time to effective breastfeeding, maternal satisfaction with the care provided, preference for the same care in future and level of exclusive breastfeeding at the age of one month were also noted. The data was compared by using X[2] and t-test. Significant p-value was taken as < 0.05. A total of 183 mother-infant pairs [92 in skin-to-skin care [SSC] group and 91 in conventional care [CC] group] were analyzed for breastfeeding behavior of the infants. The first breastfeed was 26.25% more successful in SSC group [58.8% in SSC group as compared to 32.5% in CC group with p-value of 0.001]. In SSC group, the mean time to initiate first breastfeed was 61.6 minutes shorter than CC group [40.62 vs. 101.88; p < 0.001]. Mean time to achieve effective breastfeeding was 207 minutes earlier in SSC group [149.69 vs. 357.50; p < 0.001]. The level of satisfaction in the mothers of SSC group was significantly high as compared to controls [56% vs. 6.2%]. Similarly, 53.8% mothers of SSC group showed preference for similar care in future as compared to 5% in CC group. In SSC group 85.3% infants were exclusively breastfed at one month as compared to 65.7% in CC group [p=0.025]. Maternal-infant early skin-to-skin contact significantly enhanced the success of first breastfeed and continuation of exclusive breastfeeding till one month of age. It also reduced the time to initiate first feed and time to effective breastfeeding

Ophthalmia neonatorum

To measure the frequency of ophthalmia neonatorum among all babies born in MCH Center, PIMS [Pakistan Institute of Medical Sciences], Islamabad, in one month's time and to determine their causative organisms. An observational study. The MCH Center, PIMS, during the month of November 2008. All babies born from 1st to 30th November, 2008 in the MCH Center, PIMS, Islamabad, Pakistan were included in the study. All babies were examined for signs of conjunctivitis on days 1, 3, 7, 14, 21 and 28 of life. Conjunctival swabs were taken for gram staining and culture from those with clinical diagnosis of conjunctivitis. Frequency of known maternal and neonatal risk factors for the disease were assessed. Proportions were compared using chi-square test with significance at p <0.05. Seventeen percent of the 1010 babies developed conjunctivitis. Staphylococcus aureus [65% of all positive cultures] was the most common causative organism. No case of gonococcus was isolated. Meconium stain liquor [p=0.004] and caesarain section [p <0.001] were found to be the most frequent associated conditions in conjunctivitis. There was a high frequency of neonatal conjunctivitis, with Staphylococcus aureus as the most common causative agent. Poor hygienic conditions and practices could be an important risk factor in Pakistan

Maternal periodontal disease and preterm low birth weight: an update

In the past decade, there has been mounting scientific evidence suggesting that periodontal disease may play an important role as a risk factor for adverse pregnancy outcomes. Maternal periodontal disease is emerging as a major risk factor for preterm delivery and low birth weight. Preterm birth, resulting in babies born too little and too soon, is a major cause of morbidity and child hood handicap. Data from recent studies have implicated periodontal infections as a potential independent risk factor for preterm low birth weight, but several risk factors for pregnancy outcomes, such as socioeconomic factors, smoking, diabetes and stress, have also been consistently associated with periodontitis. This review focuses on the definition, classification of periodontal disease and its plausible link to preterm low birth weight babies, incidence and the risk factors associated with preterm low birth weight. Additionally this review summarizes the current scientific data on preterm low birth weight and makes a conclusion based on current understanding of the topic. Finally, the clinical relevance of maternal periodontal health and disease has been emphasized and need of antenatal oral health care has been highlighted. It is hoped that both medical and dental practitioner world will realize the importance of maternal oral health in relation to pregnancy outcome. Ultimately, it is hoped that the quantity of life of both mother and infant would improve through early intervention and control of periodontal diseases in pregnant mothers

Maternal risk factors associated with low birth weight

To determine the association of socio-demographic, maternal, medical and obstetric risk factors with low birth weight. Design: A case-control study. Place and Duration of Study: This study was carried out in the department of Neonatology, Children Hospital and Mother and Child Health Care Centre, Pakistan Institute of Medical Sciences, Islamabad during August-September 2001. Subjects and One hundred and ninety consecutive low birth weight [<2.5kg] live born babies were enrolled cases against 760 consecutive normal birth weight [>2.5kg] babies as controls. Informations regarding maternal, biosocial, medical and obstetric complications during pregnancy were recorded on a pre-tested proforma. Data analysis was done through logistic regression model in SPSS10 and results were interpreted in terms of odds ratio and p-values. The mean weight of cases was 2.08 kg as compared to 3.1 in controls. Forty-six% of cases were preterm. The factors like maternal malnutrition, young age of the mothers, poverty, close birth spacing, hypertension and antenatal per vaginum [p/v] bleeding during pregnancy have independent effect in causing low birth weight [LBW]. Maternal biosocial, medical and obstetric factors have strong association with LBW. To overcome this problem, special attention is required to strengthen the mother and child health care services in the community

Congenital hematometrocolpos in a circumcised girl. an anomaly superimposed by cultural mutilating practices

A rare case associated with congenital hematometrocolpos in a circumcised 13 years old Somalian girl is presented. Emphasis on proper history is highlighted. Mutilation caused by bad cultural practice of female circumcision which is although not a problem in Pakistan, is brought into notice for those who may be unaware of perineal appearance of a circumcised female and stitched over vagina