OBJECTIVES: To determine the frequency of genital tuberculosis in patients undergoing diagnostic laparoscopy for infertility. METHODOLOGY: It is a descriptive (cross-sectional) prospective study. The study was performed within the duration of six months i.e., February 12th, 2020 to August 12th, 2020 at the Department of Obstetrics and Gynecology, Khyber Teaching Hospital, Peshawar. A total of 196 patients were observed by using 47.1% proportion of genital tuberculosis in infertility, 95% confidence interval with margin of error 7%, using software of WHO for sample size calculation. Further, sample collection was performed using non-probability (consecutive) sampling techniques. RESULTS: The mean age of the patients in our study was 30 years (SD+3.92). Fifty seven percent of cases were having primary infertility and 43% of patients were having secondary infertility. The incidence of genital tuberculosis undergoing infertility was 45%. CONCLUSION: Our study concludes that the incidence of genital TB in infertility in our setup was 45%.
Background: Acute Leukaemia is a malignant disorder characterized by an abnormal proliferation of immature cells, called blasts. Classically, acute leukaemia is classified into acute myeloid leukaemia and acute lymphoblastic leukaemia depending on the lineage of the immature cells. Objective of the study was to evaluate the clinical presentations, analyze the haematologic parameters at time of diagnosis and assess the post-induction status in newly diagnosed ALL patients. This cross-sectional study was conducted in the Department of Haematology, Armed Forces Institute of Pathology, Rawalpindi from June to November 2019. Methods: A total of 55 newly diagnosed ALL patients were recruited including children, adults and elderly. Detailed medical history and physical findings were noted. Haematologic parameters were documented. Each patient was treated as per standard protocol and remission induction status was determined on day 29 of treatment. Results: The median age of the study cohort of 55 newly diagnosed ALL patients was 8.5 years. Males were 37 (67.3%) and females were 18 (32.7%) with a male to female ratio of 2:1. Paediatric group included 31 (56.4%) patients. Nine (16.4%) patients were in the adult group and 15 (27.3%) in the elderly age group. The time from onset of symptoms to diagnosis of acute lymphoblastic leukaemia was 98.87±79.21 days. Fever was the most common symptom but body aches were common among paediatric group while pallor was the most common sign. Mean WBC was 29.1±27.9 x109/l, Hb was 8.1±2.9 g/dl and platelet count was 60±41.8 x109/l B-acute lymphoblastic leukaemia was more common than T-acute lymphoblastic leukaemia. A total of 52 patients were assessed on day 29 to evaluate for post-induction remission status. The remission rate of our cohort of patients was 82.7%. Conclusion: Most of the patients were in paediatric age group and remission rate was better in this age group compared to elderly population. B-ALL was associated with good response to induction chemotherapy while patients with BCR-ABL1 gene rearrangement did not respond well to treatment. Identification of prognostic features at diagnosis will further help our clinicians to predict outcomes of the disease.
OBJECTIVES: The purpose of this study was to assess suicide and their relationship with risk factors i.e. degree of hopelessness, severity of depression and suicidal ideations. METHODOLOGY: It was a cross sectional study conducted in Psychiatry unit Khyber Teaching Hospital Peshawar. The total sample of this study was forty-eight admitted patients. Those patients were included in the study that scored moderate to high in Hamilton Depression Rating Scale (HDRS), Hopelessness Scale and Reasons for Living Inventory (RLI). The collected data were analysed using SPSS version 22. RESULTS: Study showed that reasons for living as well as the subscales of reasons for living inventory i.e. responsibility towards family, hope of improvement and surviving and coping beliefs have significant inverse correlation with score on Hopelessness Scale and suicidal ideations. The score on subscale religious beliefs had significant correlation only with score on hopelessness. Married individuals’ responses were different on total reasons for living to a significant extent. The patients with past psychiatric history had significantly greater fear of suicide. The three different social groups did not differ to a significant extent in scoring on reasons for living. CONCLUSION: The reasons for living as a whole and some of the subscales of Reasons for Living Inventory have significant inverse relationship with suicidal risk factors showing the modulatory effect of these reasons on suicidal risk. Moreover, these reasons are not equally distributed among some of the sociodemographic and clinical groups.
OBJECTIVES This study aimed to evaluate the maternal and fetal outcomes in PROM and PRE-PROM at tertiary care hospitals. METHODOLOGY This Cross-sectional study was carried out in the department of obstetrics and gynaecology at Khyber Teaching Hospital Peshawar after ethical approval of the institutional ethical board. Patients who fulfilled the inclusion criteria were selected. On arrival, detailed history was taken, physical and obstetrical examination and per speculum examination were done, patients were managed conservatively, and steroid cover was given for fetal lung maturity. RESULTS A total of 150 pregnant women who met the inclusion criteria and were complicated by PROM or PRE-PROM were followed. Out of the total patients, 104 presented with PROM, while 46 presented with PPROM. PROM and PPROM patients were identical regarding placental abruption. 104(69.3%) patients presented with PROM and PPROM 46(30.7%). Patients who delivered were 72(52%) normal vaginal delivery (NVD), 57(38%) C-Section, 15(10%) NVD with episiotomy. In NVD 54(63%) spontaneous, 18(12%) induced, while in C-Section 6(4%) elective and 51(34%) emergency C-Section. In PROM, 18(12%) were complicated by chorioamnionitis, fetal distress meconium stained liquor 18(12%), whereas 100 were uneventful, while in PPROM, 122(81.3%) had no complications, 10(6.7%) chorioamnionitis and 40.7% of the neonates had NICU admission. The personal effects of NVD on the duration of PROM/ PRE-PROM in days with p-value 0.027. The p-value of Complications of PRE-PROM was 0.037. CONCLUSION PROM and PPROM presented with increased maternal and fetal morbidity, vaginal infection, and urinary tract infection should be promptly screened and treated on time to prevent maternal morbidities and improve fetal outcomes.
OBJECTIVES: The iobjective iof ithe istudy iwas ito iestimate ithe iprevalence iof postpartum idepression iand iits iassociated irisk ifactors iamong imothers. METHODOLOGY: This icross-sectional istudy iwas icarried iout iin ithe iDepartment of iObstetrics i& iGynecology,iand iDepartment iof iPsychiatry, iKhyber Teaching Hospital iPeshawar 1st April 2018 till 31st March 2019. iA itotal i750 ipost-natal imothers iwere iscreened irandomly ifor ipostnatal idepression ifor ifirst i1-2 weeks ifollowing idelivery iby iusing iEdinburgh iPostnatal iDepression iScale (EPDS). 680 iaccepted ito iparticipate, i70 irefused ito iparticipate iand i504 ifulfill ithe inclusion icriteria. iA iscore iof i≥13 iwas iconsidered ihaving Ipostpartum depression. RESULTS: A itotal iof i168 iwomen ihad ian iEPDS iscore i10, iyielding ia icrude prevalence irate iof i34%. iThe iprevalence iof isuicidal iideation iwas i14 iout iof 504 (3%), iamong iwhich i11 i(79%) ihad iEPDS iscore iof i10. iWe ifitted multiple ilinear iregression imodels ito ievaluate ithe ipredictors iof ivariables measured ion ithe iEPDS. iThis imodel iwas istatistically isignificant p<0.0001 iin ipredicting ithe itotal iEPDS iscore. iWomen's iemployment istatus, domestic iviolence iand imarital iconflict iwere istatistically isignificant predictors. CONCLUSION: Thisistudy ireflected ithe ifacts ithat imany iof ithe ipostnatal mothers iof iour icircumstances isuffer ifrom ipostpartum idepression iand ineeds medical iattention. iScreening iof ipostpartum idepression ishould ibe iconsidered as ia iroutine ipart iof ipostpartum icare. KEYWORDS: IPostpartum IDepression, Risk IFactors, Socio-Demographic IFactors, Pakistan
NUCHAL CORD PREVALENCE & PERINATAL OUTCOME IN CASES PRESENTED IN KHYBER TEACHING HOSPITAL, PESHAWAR: A TERTIARY CARE HOSPITAL.
OBJECTIVE This study aims to assess the Pap smear screening method’s accuracy in detecting precancerous lesions. METHODOLOGY After fulfilling the inclusion criteria patients were selected, the patient’s bladder was emptied and put in a dorsal position, and Cusco’s speculum was introduced after lubrication followed by insertion of Ayer’s spatula, applied on the transformational zone, and rotated in 360 degrees. Specimen smeared on glass slides and sent to the laboratory with fulfilled lab pre-requisite form. Patients were requested to follow up with a histopathology report. RESULTS Mean age of the patient was 38.111+9.461 years. Among the 77 patients whose samples were taken 15.4% were asymptomatic, 32.1% with vaginal discharge, 17.9% vaginal discharge,17.0% with intermenstrual bleeding and 16.7% were having lower abdominal pain with p-value=0.087. Histopathology reports were interpreted upon follow-up visit among those 1.3% came out to be positive for malignancy, 76.6% negative for malignancy while 22.1% had an inadequate sample. CONCLUSION The most common method for screening for cervical cancer is the Pap smear, but its efficacy in detecting early precancerous lesions is very low, possibly due to laboratory error or false technique to a gynecologist of sample technique in our tertiary care hospital. Other screening methods should be used instead of conventional Pap smear.
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