Comparison of foetomaternal outcome of vaginal delivery and cesarean section

This study was carried out to compare the maternal and neonatal morbidity associated with instrumental vaginal delivery [vacuum or forceps] with Cesarean section [C. section] at full dilatation of cervix at a tertiary care hospital. Two hundred women required operative delivery at full dilatation of cervix during the study period. Cesarean section was done in 100 patients and vaginal instrumental delivery was successful in 100 cases. Among C. section group 70 patients had immediate C. section and 30 patients had C. section after instrument failure. Among vaginal instrumental deliveries, 50 [50%] patients delivered by forceps and 50 [50%] by vacuum extraction. Mean age of study population was 25.35 +/- 4.65 years. Haemorrhage [blood loss > 1 litre] was more common, 16 [16%] for C. section than 4 [4%] for vaginal delivery irrespective of delivery mode p< 0.018. Discharge within 48 hours was more likely after vaginal instrumental delivery than after C. section. There were no perinatal deaths. Babies were more likely to be admitted to the nursery after C. section as compared to instrumental vaginal delivery

Knowledge and attitude of older women towards menopause

To assess the knowledge and attitude towards menopause in postmenopausal women and to determine associated socio-demographic features such as the age, parity, social and educational status of such women. Descriptive, observational. January 2004 to November 2004. Out patient department, Sir Ganga Ram Hospital, Lahore. A total 200 postmenopausal women aged 50 and above were interviewed in the outpatient department to assess their knowledge about menopause and their attitude postmenopausally whether positive or negative. Mean age at menopause was 48.9 years. Sixty five percent women were satisfied with cessation of menstruation mostly because of religious background. However 3% desired to continue menstruation while 5% women were unhappy with their menopausal status. Twenty four percent women perceived no change in behavior. About 50% women had knowledge about menopause and its symptoms. Only a small percentage of women had knowledge about sequel of menopause and its treatment. The average age at menopause in Pakistan is around 49years. Most Pakistani women are multiparous or grand multiparous especially rural women. Knowledge about menopause, its sequel and treatment to improve quality of life is limited. Pakistani women take menopause positively on religious grounds. There is a need to conduct population based studies on the knowledge and awareness of women towards menopause, so as to formulate a countrywide health education strategy

Role of fine needle aspiration cytology [FANC] in diagnosis of uni-locular ovarian cysts - a Cytohistological correlation

This study was carried out to assess the ability of fine needle aspiration cytology [FNAC] in the diagnosis of ovarian cysts by comparing the results with histological findings of tissue biopsies. This study includes 48 cases by ovarian cysts reported to Pathology department, Allama Iqbal Medical College, Lahore and Author's Lab. mainly from Jinnah Hospital, Lahore, Sir Ganga Ram Hospital, Lahore and Services Hospital, Lahore. In 28 cases, aspiration was done per-operatively while in 20 cases preoperatively. These aspirates were examined cytologically by making the appropriate smears. The same cysts removed surgically were then examined histologically and results were compared. In a total of 48 cases, on FNAC, serous, follicular, luteal, mucinous and endometriotic cysts were diagnosed in 12, 8, 7, 5 and 5 cases respectively with inconclusive aspirate in 11 cases. When histology was done on excised specimens of these ovarian cysts, serous cysts were found in 17 patients, follicular cysts in 10, luteal cysts in 12, mucinous cysts in 6 and endometriotic cysts in 3 patients. On correlating the FNAC and histopathology results, a sensitivity of 58.34% to 100% and a specificity of 60% to 100% were calculated in different types of cysts. It is concluded that FNAC of ovarian cysts is a fairly useful diagnostic technique which can further improve by more experience and ancillary techniques

Pattern and frequency of various utrine tumours: a retrospective study over a period of 26 months

This is a retrospective study to find out the frequency of various uterine tumours. It includes hystrectomy specimens, tumour excisions and endometrial curettings which were sent to Department of Pathology, Allama Iqbal Medical College, Lahore and author's laboratory during a period from January 2001 to March 2003. A total of 471 cases are analysed. Leiomyomas were seen in 369 patients [78.34%] and endometrial polyps in 49 cases [10.41%]. Malignant tumours were found less frequently with adenocarcinoma in 23 patients [4.88%] followed by leiomyosarcoma in 8 patients [1.70%], Endometrial stromal tumours in 7 patients [1.49%], Choriocarcinoma in 6 patients [1.27%] and Mixed Mullarian tumours in three patients [0.64%]. NonHodgkin's Lymphoma was seen in one patient [0.21%] while in five patients [1.06%], metastatic tumours were found. Three were squamous cell carcinomas, two from cervix and one from lung while two were invasive ductal carcinomas coming from breasts. It is concluded that in the uterus benign tumours and tumour like conditions are more common with leiomyomas as the most common uterine neoplasms whereas malignant tumours are less common and endometrial adenocarcinoma being the most common uterine malignant tumour