Evaluation of ocular injuries associated with mid-facial trauma

The aim of this study was to evaluate frequency, etiology and association of ocular injuries with fractures in the middle third region of face. 129 patients with mid-face fracture were included in the study. An elaborated history was taken regarding trauma, followed by assessment of patients clinically and characteristics of fracture and associated ocular injuries noted. Out of 129 in total 52 patients [40.3%] sustained ocular injuries. Frequencies for gender involvement were 38[73.1%] male and 14 [26.9%] female patients. The most common etiology associated was Road Traffic Accident [RTA] 25 [48.1%] followed by Assault 11[21.2%], Fall 8 [15.4%], sports injury 5 [9.6%] and Firearm injury [FAI] 3[5.8%]. Subconjuctival Hemorrhage [71.15%] was the most common ocular injury found to be associated with mid facial fracture in this study. Other ocular complication found in these patients were Diploipa [19.23%], decreased visual acuity [17.3%], Enophthalmous [9.61%], Hyphema [5.76%] and blindness as 3.85%

Impact of maternal anemia on perinatal outcome

To evaluate the effect of maternal anemia on perinatal outcome. Cohort study Department of Obstetrics and Gynecology, Liaquat University Hospital Sindh Pakistan from March 2007 to December 2007. A total number of 1012 women were delivered during the study period. All singleton pregnant women who attended the out patient department before 18 weeks of gestation were included while women with multiple pregnancies, past history of preterm delivery and medical illness except anemia were excluded from the study. Relative risk and a 95% confidence interval were calculated through. Demographic and socioeconomic features of both groups were compared by Chi-Squared test using SPSS 17. A p-value of or less than 0.05 was considered as significant. A total of 818 women fulfilled the inclusion criteria, 407 in anemia group and 411 in non-anemic group. Hemoglobin range of anemic group was from 5 to 10 gram/dl. While in non anemic group hemoglobin ranges from 11 to 13gram/dl [mean11.87 +/- 0.54]. Risk of premature birth and low birth weight among anemic women was 3.92 and 2.2 times more than nonanemic women, which was statistically significant. Risk of IUGR was 2.2 times greater in anemia than non-anemic group. However this was statistically significant. Our study shows that risk of preterm delivery and low birth weight were greater in anemic group than non anemic group, which was statistically significant. Preconceptional evaluation along with planned pregnancy is important in decreasing the frequency of maternal anemia and its effect on fetus and newborn

Emergency obstetric hysterectomy frequency and maternal outcome

To review the frequency, indications and maternal outcome of emergency obstetric hysterectomy. Descriptive study. In obstetrics and gynecology department of Nawabshah Medical College Hospital Sindh from 2nd May 2005 to 31st April 2008. During the study period total 3089 patients were delivered. Out of these, 37 patients underwent cesarean hysterectomy. Records of all the patients were analyzed. The parameter analyzed were age, parity, social status, booking status, indication for operation, operative notes, maternal outcome, complications and postoperative status. Mortality register was also checked for the causes of maternal deaths. During the study period, there were 3089 deliveries. Amongst these 37 had emergency obstetric hysterectomies giving rise to a frequency of 11.9 / 1000 cases. Regarding parity, 23[62.1%] were multiparous, 12 [32.4%] patients were grand multiparous and 2 [5.4%] patients were primiparous. Commonest indication of emergency obstetric hysterectomy was postpartum hemorrhage due to uterine atony which was seen in 13[35.1%] cases, followed by ruptured uterus in 11[29.7%] cases, placenta previa in 6[16.2%] cases, and couveliar uterus in 5 [13.5%] cases and placenta accreta in 2 [5.4%] cases. Commonest maternal complications were urinary tract infection in 6[16.2%] patients followed by DIC in 5[13.5%] patients. Maternal mortality was seen in 2[5.4%] patients. In our study frequency of emergency obstetric hysterectomy was high. Most common indication was rupture uterus, post partum hemorrhage due to atony uterus and placental causes. After UTI, disseminated intravascular coagulation was most common complication seen. 2patients were expired. Sever Emergency obstetric hysterectomy when performed in selected cases at an appropriate time helps in bringing down maternal mortality

Awareness of women regarding analgesia during Labour

Delivery pain is one of the most severe pains that women experience during their life so a change can affect all dimensions of pregnant women and her family life. Aim of this study was to assess the women's knowledge of pain relief during labour, and their beliefs, fears, and misconceptions regarding epidural analgesia. It was descriptive study conducted in Obstetric and Gynaecology OPD of Liaquat University of Medical and Health Sciences, Hyderabad from September 2007 to January 2008. Women were selected randomly. All pregnant females who had delivered previously were interviewed. Primigravida were excluded from study. Information was collected on self-made questionnaire after an informed consent. Information was collected on computer software programme of SPSS 11.frequencies and percentages were calculated to express the results. Total 131 women were included in this study. Out of these 65, [49.6%] had no education while 41 [31.2%] had primary education. Majority of women [82, 62.5%] had knowledge about injections while few [12, 9.1%] women had knowledge about epidural analgesia. Seventy-nine [60.3%] had chosen the injections as preferred method during next labour. Regarding attitude towards labour pains, 61 [46.5%] feels that labour pains as severe pain. Regarding epidural analgesia 4 [3%] women thought that epidural analgesia will lead to weakness of limbs and 3 [2.2%] women thought that it will cause permanent backache. There was poor general awareness of women about the role of epidural analgesia in labour leading to a low patient demand for such services. Most of the women had gained knowledge regarding pain relief from past experience or from friends and relatives

Frequency and indications of cesarean section in a tertiary care hospital

To determine the frequency of cesarean section and to analyze the indications, so as to introduce measures to control the cesarean section rate. This descriptive study was conducted in obstetric and gynecology department of Isra university hospital Hyderabad Sindh from 1st Jan 2007 to 31st Dce 2007.In this study clinical record of all the patients who underwent cesarean section was analyzed. It included all the pregnant ladies booked in the antenatal clinic and unbooked patients admitted in early labour for whom cesarean section was indicated later. It also included all those cases coming in emergency at any time for which cesarean section was indicated. Clinically diagnosed cases of ruptured uterus proved on laparotomy were not included in the study. Data was analyzed on SPSS version 11 and frequencies as wall as percentages were calculated. During one year study period, 380 cesarean section were performed. The rate of cesarean section was 64.7%. Emergency cesarean section was performed in 225 [59.2%] patients and elective cesarean section in 155 [40.7%]. Among 380 patients, 167 [43.9%] were booked while 213 [56.0%] were unbooked. Repeat cesarean section was the commonest indication seen in 73 [19.2%] patients followed by dystocia in 51 [13.4%] patients, fetal distress in 48 [12.6%] and ante partum hemorrhage in 45 [11.8%] patients. Miscellaneous indications contributed to 16 [4.2%] of the cases. Majority of patients who underwent cesarean section was unbooked and had an emergency cesarean section. The commonest indication was repeat cesarean section

Eclampsia; frequency and morbidity

The purpose of our study was to find the outcome, frequency, maternal morbidity and perinatal outcome due to eclampsia in our set up. Descriptive study. This study was conducted in the department of obstetrics and gynae from 1st January 2007 to 1st January 2008 in Gynecology and obstetric department: unit 1 of Liaquat University hospital Hyderabad. Total 39 patients who had eclampsia were included in this study while other obstetric patients who had no eclampsia were excluded from the study After an informed consent information was recorded on predesigned proforma regarding maternal age, parity, duration of pregnancy, B.P at admission mode of delivery maternal morbidity and perinatal outcome. Results were analyzed through computer software programme SPSS version 11 and percentages were used to describe the data. Total 1415 deliveries were conducted during the study period. Out of these 39 patients had eclampsia. So the frequency of eclampsia was 2.7% Majority of patients i.e. 15 [38.4%] were less than 20 years. Out of 39 patients 32 [82.0%] patients were primigravida while 4 [10.2%] were multigravida and 3 [7.6%] patients were grandmultigravida. Majority of the patients i.e. 28 [71.7%] were unbooked. 18 [46.1%] patients had fit during antenatal period 14 [35.8%] patients had fit in postpartum period one case with eclampsia was received on 6th postnatal day. Serious maternal morbidity was pulmonary edema seen in 6 [15.3%] HELLP Syndrome in 3 [7.6%] and acute renal failure in 4 [10.2%] patients. Regarding perinatal outcome 28 [71.7%] babies were born alive out of these 11 [39.2%] were died in early neonatal period 8 [20.5%] babies born, were still birth while 3 [7.6%] were macerated IUD. In our study majority of patients who developed eclampsia were young and primigravida Major maternal morbidity was pulmonary edema chest infection and acute renal failure. Perinatal mortality was also high

Laparoscopic evaluation of chronic pelvic pain: experience at a public sector university hospital

To evaluate laparoscopically the causes of chronic pelvic pain in our set-up, so that appropriate treatment could be offered to these patients and unnecessary hospital visits and repeated use of antibiotics are avoided. A descriptive study. Obstetrics and gynecology outpatient department [OPD] of Liaquat University Hospital Hyderabad, Sindh - Pakistan from 1[st] October 2006 to 31[st] March 2007. This study was based on sample of convenience and conducted on women who attended OPD. A total of 4301 patients attended the OPD. Among them, 271 patients attended the OPD because of chronic pelvic pain. They were thoroughly interviewed and investigated. Those patients who did not respond to symptomatic treatment were advised laparoscopy. Thirty-three patients who fulfilled the inclusion criteria and gave consent were selected for laparoscopy. Informed consent was taken and detailed history, thorough examination and necessary investigations were carried out. Patients with serious heart or lung disease, peritonitis, intestinal obstruction, abdominal operations and malignancy were excluded. Diagnostic laparoscopy was carried out under general anesthesia and operative findings were noted on a proforma. Data were analyzed through software programme SPSS version 11.0. Of these 33 patients, majority 17[51.52%] belonged to 31-41 years of age group and were multiparous patients [57.58%]. Seventeen [51.52%] patients had dull, deep pelvic pain with occasional sharp episodes. Only 03[9.1%] patients with acute pain required hospitalization. Eleven [33.33%] patients complained of subfertility, 7[21.21%] had dysmenorrhea while 05[15.15%] had dysfunctional bleeding. Only 04[12.12%] patients complained of backache low down in the lumbosacral region. No any sign was present in 7[21.21%] patients. Uterus was bulky in 11[33.33%]patients. Adnexal masses were felt in 06[18.18%] patients while 05[15.15%] had nodularity in pouch of Douglas. Regarding laparoscopic findings, 11[33.33%] patients had chronic pelvic inflammatory disease. Varying degree of endometriosis was seen in 09[27.27%] patients. In 04[12.12%] patients, no abnormality was detected. This study emphasizes the importance of laparoscopy in evaluating the cause of chronic pelvic pain. This procedure shall be considered an essential investigation in the management of such patients so that repeated and unnecessary use of antibiotics and other drugs could be avoided

Asymptomatic bacteriuria in pregnancy

To determine the frequency and risk factors of asymptomatic bacteriuria during pregnancy. Descriptive study. In obstetric and gynecology outpatient department of Isra university hospital Hyderabad Sindh from 2 nd July to 10 th December 2007. Total 111 women were included in the study. Inclusion criteria were pregnant women with no clinical features suggestive of UTI. Symptomatic women, women with any medical or renal disease and those who had taken antibiotics in last 6 weeks were excluded from the study. Dipstick test was performed on MSU and urine was cultured incase of positive dipstick. Data was analyzed on SPSS version 11. Frequencies were runned and chi-square test was used as test of significance. A total of 111 women fulfilling the inclusion criteria were interviewed and tested for bateriuria. Out of them 10% [9%] had bacteriuria. Out of them 10% were below 20 years and 90% were between 20-30 years [p=0.17]. Regarding education 10% were literate and 90% were illiterate [p=<0.001]. Prevalence of bacteriuria was 100% in women who had past history of urinary tract infection [p=0.004]. 80% of women who were sexually active had bacteriuria while 20% had not [p=0.006]. No association of bacteriuria was found with anemia, age, parity and socioeconomic condition. Asymptomatic bacteriuria is a common infection during pregnancy, have strong association with education, past history of urinary tract infection and illiteracy

audit of cesarean sections in a teaching hospital

To determine the frequency of factors responsible for apparently high cesarean section rate in teaching hospital, Liaquat university hospital Hyderabad and to assess maternal morbidity and fetal out come after cesarean section. Descriptive study. In obstetric and gynecology Department of Liaquat university hospital Hyderabad Sindh Pakistan from 3 rd January 2007 to 2 nd January 2008. Total 1666 deliveries were conducted in year 2007 to 2008. Out of these 584 were delivered by cesarean section and 1082 were delivered by normal vaginal delivery. Clinical record of all the patients who underwent Cesarean section was analyzed. All the patients who underwent cesarean section were included in this study while clinically diagnosed cases of ruptured uterus and proved on lapratomy were excluded from this study. A proforma of each patient was completed, regarding the relevant information of cesarean delivery and fetal outcome. Cesarean section was done on 584 [35%] patients while normal vaginal delivery was conducted on 1082 [65%] patients. A total of 149 [25.5%] patients' underwent elective cesarean section while in 435 [74.4%] patient's cesarean section was done in emergency. A total of 144 [24.7%] patients were booked while 440 [75.3%] patient's were unbooked. Most common indication of cesarean section was repeat cesarean section, which was seen in 182 [31.2%] patients. Among obstetric complications major problem encountered was massive hemorrhage, which is seen in 64 [11%] patients wounds sepsis was second most common complications. A total of 453 [77.6%] newborns were born alive and 50 [8.6%] neonates were dead which included fresh and macerated still birth. 81 [13.8%] neonates died later on in pediatric unit [END]. The rate of cesarean section in our study was 35%, which is quite high. Commonest indication of cesarean section observed in this study was previous cesarean section. Majority of patient's who underwent cesarean section were unbooked. Commonest obstetric complication was massive hemorrhage followed by wound sepsis. Perinatal mortality was also high in this study

Awareness of women regarding Hepatitis B

Hepatitis B is the major health problem globally casting an enormous burden on health care system and major source of patient's misery. It is also an important cause of hepatocellular carcinoma and is likely to remain a serious health problem resulting in substantial morbidity and mortality for several decades to come. Objective of the study was to determine the level of awareness regarding hepatitis B among women attending obstetric and gynaecology clinic at Isra university Hospital. It was descriptive study and conducted in Obstetric and Gynaecology, Outpatient Department of Isra University Hospital, Hyderabad, Sindh from 2nd January to 3rd June 2008. Total 121 women of 20-50 years were gathered by sample of convenience. Information was collected on predesigned questionnaire containing questions regarding basic knowledge of disease, its causative organism, route of transmission and its prevention. Informed consent was taken. All the data was analyzed by computer software Programme of Social Sciences [SPSS version 11.0]. Out of 121 women, 82 [67.76%] women correctly responded that virus is a cause of hepatitis. When they were asked about the organs affected by hepatitis B infection, 91 [75.20%] correctly mentioned liver, while 30 [24.79%] gave incorrect answer. Regarding mode of transmission of HBV 41 [33.88%] mentioned infected blood transfusion, 49 [40.49%] contaminated needles, 46[38.0%] un-sterilised instruments, 21 [17.35%] from mother to child and only 23 [19.0%] mentioned sexual intercourse. Only 51 [42.14%] women knew that vaccine is available for prevention. This study found that the knowledge about hepatitis B virus among women is inadequate and there are certain misconceptions regarding its mode of transmission through sharing room, touching etc which needs to be clarified. Majority of women don't know that HBV infection can be prevented by using condoms