Ovarian malignancy is a serious disease affecting women of all ages, more so above 50 years, and they are still difficult to treat, partly because no truly effective therapy has yet been developed although presentation is often vague and non-specific, the symptoms are definitely present. It is important to recognize the symptoms so far, there is no test yet available, which is truly specific and suitable for screening and early detection of epithelial ovarian carcinoma. So, it is concluded that for prognosis and patient survival, early detection and treatment is mandatory.
Objective: To evaluate increasing rate of caesarean section due to non-reassuring cardiotocography. Methods: This study is carried out in obs/gyn department of Liaquat university hospital from 2012 to 2013. After permission from ERC, patients enrolled for study meeting inclusion criteria with nonreactive cardiotocography undergo caesarean section, and results are analysis through SSPS version 17. Results: There was wide variation of maternal age ranging from a minimum of 20 years to 30 years. The mean age was 26 ± 2.1 years. In our study mostly patients were primigravida 58 (58%) between 2 -4 were 22 (22%) more than para 5 were 20 (20%) patients. In our study mostly patients undergone caesarean section 81 (81%) 19 delivered vaginally (19%). In our study the gestational age was >37 weeks, ranging from a minimum of 37 weeks to 42 weeks. The mean age was 37 + 2.4 week. Mostly patients observed 37 -38 wks in (52.67%), 39 -40 wks in (32.14%) and 41 -42 wks in (15.17%). In our study mostly Apgar score were more than 7 was 63 (63%) cases and less than 7 Apgar score in 37 (37%). Conclusion: Cardiotocography is a useful and indispensable adjunct to monitor the condition of endangered fetus. However, there is a need to develop a standardized and unambiguous definition of FHR tracing to reduce the incidence of false positive findings that may result in increased incidence of unnecessary intervention particularly caesarean section.
ObjectivesContributing factors to COVID-19 vaccination intention in low-income and middle-income countries have received little attention. This study examined COVID-19-related anxiety and obsessive thoughts and situational factors associated with Pakistani postpartum women’s intention to get COVID-19 vaccination.DesignCross-sectional study administering a survey by a telephone interview format between 15 July and 10 September 2020.SettingFour centres of Aga Khan Hospital for Women and Children—Garden, Kharadar, Karimabad and Hyderabad—in Sindh Province, Pakistan.ParticipantsWomen who were enrolled in our longitudinal Pakistani cohort study were approached (n=1395), and 990 women (71%) participated in the survey, of which 941 women who were in their postpartum period were included in the final analysis.Primary outcome measure and factorsCOVID-19 vaccine intention, sociodemographic and COVID-19-related factors, Coronavirus anxiety, obsession with COVID-19 and work and social adjustment were assessed. Multiple multinomial logistic regression analysis was used to identify factors associated with women’s intentions.ResultsMost women would accept a COVID-19 vaccine for themselves (66.7%). Only 24.4% of women were undecided about vaccination against COVID-19, and a small number of women rejected the COVID-19 vaccine (8.8%). Women with primary education were less likely to take a COVID-19 vaccine willingly than those with higher education. COVID-19 vaccine uncertainty and refusal were predicted by having no experience of COVID-19 infection, childbirth during the pandemic, having no symptoms of Coronavirus anxiety and obsession with COVID-19. Predictors for women’s intention to vaccinate themselves and their children against COVID-19 were similar.ConclusionUnderstanding the factors shaping women’s intention to vaccinate themselves or their children would enable evidence-based strategies by healthcare providers to enhance the uptake of the COVID-19 vaccine and achieve herd immunity against Coronavirus.
Efficacy and safety of intra-vaginal prostaglandin E2 pessary for induction of Labor. Objectives: To evaluate the efficacy and safety of intra-vaginal prostaglandin E2 pessary for induction of Labor. Study Design: Case control study. Setting: Gynecological and obstetric ward of Liaquat University of Medical and Health Sciences Hospital, Hyderabad. Period: 14 Feb 2012 to 13 Feb 2013. Study Population: All the Pregnant women at term or post term admitted in gynae ward from 14th February 2012 to 13th February 2013. Results: 100 women recruited in the study, study carried out at Gynecological ward of Liaquat University of Medical and Health Sciences Hospital Hyderabad. Analysis of booking status listed in Table-I revealed that 68% (n = 68) were un-booked having no antenatal care and 32.0% (n = 32) were booked. There were no protocol violation, relation to the parity listed in Table-II showed maximum number of patients (n = 62) 62.0% Primigravida and (n = 38) 38.0% multigravidas were include. Age distribution is listed in Table-III maximum patients (n = 49) 49.0% at age between 26 -35 years, 35 (35.0%) were between 20 -25 years, 10 (10.0%) were >35 years and 06 (6.0%) patients were belong to less than 20 years. Regarding the gestational age 57 (57.0%) patients in our study presented between 37 -39 weeks of gestation. However, 47 (47.0%) patients were at 40 ->40 weeks of gestation showed in the ( Table-IV). Indication for cervical ripening and induction of labor is listed on Table-V commonest indication was pregnancy induced hypertension followed by prolonged pregnancy, and IUGR etc. Table-VI shows the Bishop score 30 (30.0%) had Bishop Score 2 -3, while 70(70.00%) had a bishop score 4-5. Table-VII shows induction-delivery interval, Greater number of women (66/100) delivered within 24 hours of start of induction. Table-VIII showed mode of delivery, majority of the women had normal vaginal deliveries 64.00 while 16 deliveries by assisted vaginal deliveries while in remaining 20 cases caesarean section done. Table-IX shows four babies had an Apgar score 4/10 at end of 1 min and 7/10 at end of 5 min, whereas 96 babies had an Apgar score of 9/10 in 1 min. The indications for caesarean section are shown in Table-X. There were 09(9%) cases of failed induction, 11 cases of a fetal distress (Meconium stained liquor). There was no increased incidence of neonatal sepsis or Chorioamniotis or puerperal sepsis in any of our patients. No perinatal morbidity or mortality or any severe maternal complications were noted while mild side effects were noted which is mentioned in (Table-XI). Conclusion: In developed countries prostaglandin E2 are widely used for ripening of unfavorable cervix in induction of labor but patient response vomiting, diarrhea, tachycardia, and fever are commonly observed minor side effects. Induction with Prostaglandin reduced the rate of pregnancies progressing beyond 41 weeks and related feto-maternal morbidity and mortality. After excluding contra indication all women should be offered induction at...
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