Bacterial vaginosis is the most common vulvovaginal infection and representsthe 35% of all the infections occurring in women in the reproductive age. Serious forms ofcan induce several complications such as spontaneous preterm labour and preterm birth, latemiscarriage and postpartum endometritis, PID, infertility, vaginal cuff infection and postabortalsepsis. Objective: To compare the efficacy of vaginal metronidazole and vaginal clindamycinin the treatment of bacterial vaginosis. Study Design: Interventional: Quasi experimental study.Setting: Obstetrics outpatient department, Ghurki Trust Teaching Hospital, Lahore. Durationof study: Six months i.e. from 01-01-2009 to 30-06-2009. Results: Mean age of patients wasfound to be 24.33 years. In the 100 patients enrolled, no statistically significant difference wasfound between Clindamycin 2% vaginal cream compared with metronidazole 0.75% vaginalgel using Amsell’s criteria. Metronidazole has a failure rate of 13% while failure rate was 6% inthe clindamycin group. Conclusion: A 3 day regimen of clindamycin 2% vaginal cream wasas effective as 5 day regimen of metronidazole 0.75% vaginal gel in the treatment of bacterialvaginosis.
A questionnaire about blood bank policies and procedures was prepared and sent out to 170 hospitals across the nation, 50 per cent responded. There is wide variation in both technical and nontechnical policies and procedures. Serum is separated from the original tube within 8 hours by 68 per cent of the hospitals and in 32 per cent serum is never separated from the original tube. Auto-control is included by 66 per cent of hospitals in at least one phase of the antibody testing, 34 per cent do not include auto-control in any phase. Du testing of the recipient is done in 85 per cent of the hospitals and in 15 per cent Rho type is determined by the immediate spin reactions alone. Slide type is the only method used to determine ABO group of cells of the recipients in 10 per cent of the hospitals, 18 per cent use serum-cell suspension, 10 per cent use the applicator stick method and only 62 per cent use washed saline-cell suspension routinely. Compatiblity testing between a recipient and a donor vary from a one-tube major crossmatch to a three-tube major crossmatch and minor crossmatch.
Objective: To determine the effectiveness of transdermal patch of glyceryl trinitrate as tocolytic agent. Study design: Interventional- Quasi experimental study. Setting: Department of Obstetrics and Gynecology Unit- 1, Services hospital, Lahore. Duration with dates: One year (February 10, 2006 – February 10, 2007). Sample size: Fifty pregnant women with preterm labour were included in the study. Results: 54% of pregnant women were between G2 – G4. Majority (48%) of the women presented between 31 – 34 weeks of gestation. 46% of pregnant women had bishop score of 4 or more. 64% of patients found to have no risk factor for preterm labour. Majority (86%) responded after application of second patch (10 mg glyceryl trinitrate patch). 84% had no side effects. Local skin reaction (10%) and headache (4%) observed in few patients. 58% of pregnant women delivered after 48 hours and 78% of them delivered vaginally which was statically significant and majority of babies delivered weight more than 1.5 kg and with good Apgar score. Conclusions: It is concluded from the study that glyceryl trinitrate is a safer tocolytic, which has simple method of application; rapid onset of action with low cost, low risk from side effects and it does not require intensive monitoring.
Objective: To evaluate the colposcopic findings and biopsy results in patients with abnormal cervical smear reports. Studydesign: Interventional-Quasi experimental study. Setting: Department of Obstetrics and Gynecology, Unit-I, Services Hospital, Lahore.Period: Six months (June 21, 2007 to December 20, 2007). Material and Methods: Fifty patients were included according to inclusion criteria.Results: Mean age of the patients was found to be 32.8±7.3. Maximum patients were > para 4. 44% pap smears were with grade-II dyskaryosis.41 patients were found with acetowhite area, their biopsy findings showed 24.5% CIN-II cases. Same results were found in iodine negativeareas and biopsy in mosaic pattern showed 25% cases. Conclusions: Cervical cancer is a cause of morbidity and mortality amonggynecological malignancies, but with the help of non invasive technique like colposcopy it can be detected in its earlier stages where definitivecure is possible.
Induced Miscarriage is defined as the elective termination of pregnancy before 24 weeks of gestation. Objectives: To determinethe frequency of sepsis associated with induced Miscarriage. Study Design: Cross-sectional survey. Setting: Department of Obstetrics andGynaecology, Unit-II, Ghurki Trust Teaching Hospital, Lahore. Duration of Study: Six months from 25-12-08 to 24-06-09. Materials andMethods: Total 110 cases were taken. Complete history including parity and mode of admission was taken. All information was recorded onspecially designed proforma. Results: A large number of patients turned out to be para 3-4 i.e. 87 (79%), 15 cases (13.7%) had the paritybetween 5-7 and only 8 cases (7.3%) were para 1-2 (Table-I).On analyzing the mode of admission it was found that 50 (45.4%) patients wereadmitted through out-patient department. 60 cases (54.6%) were admitted through emergency (Table-II). Finally the frequency of sepsisamongst women presenting with Miscarriage was calculated and it was found to be 25 (22.7%). 85 (77.3%) cases did not show any evidence ofsepsis (Table-III). Conclusions: Illegal Miscarriages are a major contribution to septic morbidity leading to a large number of maternal deathswhich is a dilemma in under developed countries like ours. Better public awareness and access to contraceptive measures has a definite role toplay in improving the outcome.
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