The post-partum period is considered as an ideal period for propagating any birth control technique as women are highly motivated and a number of them are under some medical care. For the introduction of an intra-uterine con-
Objective: To examine the overall diagnostic and the surgical outcomes among lactating females of breast abscesses who were treated using minimally invasive procedures. Methods: This descriptive case series study was conducted during the seven months from May 2019 to November 2019. At the general surgery department of Liaquat University of Medical & Health Sciences, Jamshoro, treated 60 lactating female patients with probable breast abscesses, with an age of more than 18 years. Percutaneous drainage insertion and ultrasound guided fine needle aspiration (FNA) were used in the treatment of breast abscesses in a minimally invasive manner. Ultrasound-guided fine needle aspiration was performed during drainage installation, followed by the insertion percutaneously of the ordinary drainage catheter through a prick incision. Data was collected by study proforma and SPSS version 20 was used for the analysis of data. Results: Average age of the females was 40 years. Clinical inflammation like puerperal mastitis was in 24(40%) patients, non-puerperal mastitis was in 27(45%) of the cases and other inflammation like as folliculinids and infected seroma were in 9(15%) patients. Fibrocystic variation was seen in 58 percent of the participants. 67 percent of non-puerperal mastitis patients had fibrocystic variations, 17 percent of puerperal mastitis patients had fibrocystic variations, and 56 percent of the other patients with other inflammatory forms had fibrocystic variations. Early problems occurred in 12 of every 60 patients (20%) whose are treated using minimally invasive procedures. Conclusion: As per study conclusion, fine needle aspiration (FNA) as per ultrasound guidance minimally invasive therapy combined with antibiotic treatment was observed to be the effective treatment approach for breast abscesses, and it is also a feasible and safe in terms of less post-operative recovery duration, complications, and hospital stay. Keywords: lactating mothers, Abscess, breast, surgery
Objective: To analyze diagnostic and surgical outcomes in patients with extremely large ovarian cysts treated by laparoscopic surgery. Methods: A total of 120 cases of large adnexal masses and suspected for malignancy were treated laparoscopically at the at general surgery department of Liaquat University of Medical & Health Sciences. Under endotracheal anesthesia, all surgeries were performed using nasogastric tubes in the stomach. An incision of approximately 1.5 centimeter was made at the supraumbilical or umbilical region and peritoneal cavity was approached. The intra-abdominal approach in all cases was cautiously standardized. The resection of the adnexal mass was performed as per routine method. Results: 12 females were premenopausal and 8 were postmenopausal. 12 women presented with the signs of urinary retention, urinary urgency and abdominal pain. Incidental sonography detected cysts in 8 patients which were asymptomatic. The average volume of the resected cystic fluid was 3000ml (range 900 to 9000 ml). The specimens of frozen section were obtained within the surgical procedure in all patients except 2 patients having para-ovarian cysts. The histopathology presented mucinous benign cystadenoma. There was no blood loss and related other complications reported in all operations. Conclusion: Laparoscopic management of large ovarian cyst observed to a effective, feasible and less complicated surgical option. However accurate selection and diagnosis of the patients, the any ovarian cyst size can be treated easily via laparoscopic surgery.
Background Infants need to be exclusively breastfed up to six months of age, and breastfeeding should be continued up to two years of age along with complementary food. In Pakistan, the majority of newborns are not exclusively breastfed. This study was done to compare weight gain between breastfed infants and non-breastfed infants at a tertiary care hospital in Karachi, Pakistan. Methodology This observational cohort study was conducted at the well-baby clinic and vaccination center of the National Institute of Child Health, Karachi, Pakistan, from January 2021 to December 2021. A total of 360 normal term babies (180 in each group) with age below 11 months on either exclusively breastfeeding or other milk feed were included. Data were collected by the duty senior staff nurse of the well-baby clinic and monitored on daily basis by the researchers. The sociodemographic characteristics of mothers of breastfed and non-breastfed babies and birth weight, length, and BMI Z scores of babies in both groups were compared. Results In a total of 360 babies, there were 192 (53.3%) boys and 168 (46.7%) girls. Overall, the mean maternal age was calculated to be 28.1±6.2 years, ranging between 18 and 37 years. The employment status of mothers (p=0.0117) and monthly income of parents (p=0.0388) were significantly different between groups. The mean weight gain in the exclusively breastfeeding group was 4.0±0.5 kg between the first and fifth visit (final visit) in comparison with 4.5±0.5 kg in the non-breastfeeding group (p<0.0001). Conclusion Non-breastfed babies gained significantly more weight in comparison with exclusively breastfed babies. More multicenter trials involving a large proportion of populations are needed to further verify the findings of the present study.
Objective: To observe the severity of the perineal trauma and its risk factors among women who developed perineal tears during vaginal delivery. Material and methods: This descriptive cross-sectional study was conducted at the Obstetrics and genecology department of LUMHS, Hyderabad, Pakistan, from September 2016 to August 2017. All the women who developed perineal trauma during vaginal delivers, age 18–40 years, singleton pregnancy, both primiparous and multiparous were included. After delivery, patients who had developed perineal tears were assessed for its severity and risk factors. Perineal tears were categorized as per severity in four categories All the data were collected via study proforma and for the analysis of data, the 26 versions of SPSS were employed. Results: A total of 100 cases were studied in the study and most of the patients 45.0% were in the age group of 15–25 years. The average gestational age was 38.2+4.1 weeks. Primiparous cases were 65.0%. Un-booked women were 65.0%. 30.0% underwent mediolateral episiotomy and 19.0% with a midline cut extension. Most of the women 41.0% were delivered by NVD, followed by 26.0% by assist vaginal delivery and while 33.0% women underwent instrumental vaginal delivery. According to the birth weight the 40.0% babies weighing more than 2.5 kg. 40.0% females had a first-degree perineal tear, followed by 32.0 percent had a second-degree tear, 19.0 percent had third-degree tear, and 10.0 percent had a fourth-degree perineal tear. Conclusion: Perineal trauma of 3rd and 4th degree were observed to be 19% and 10%, respectively. Maternal age less than 25 years, primiparity, un-booked status, use of the oxytocin, previous history of the vaginal surgeries and fetal weight >2.5 kg were observed the risk factors of the perineal tear. Key words: NVD, Severity of perineal tears, risk factors.
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