Vesicovaginal fistulas (VVF) also known as vesicovaginal fistula, have become a growing public health concern especially of developing countries. The most cited reason in literature of VVF is by prolonged and obstructed labor. With improvement in quality care delivery in health around the globe, the etiology of VVF too evolving in the country. Objective: This study was done to find out the factors associated with vesicovaginal fistula and to determine the success rate of operative procedure for treatment of vesicovaginal fistula. Method: This cross sectional study was carried out in Department of Gyneacology and Obstetrics in Liaquat University Hospital, Hyderabad from January 2021 to December 2021 among 60 women at different ages suffering from vesicovaginal fistula due to gynaecological or obstetrical causes or malignancy. Result: Majority of the patients were “young primipara with short stature and malnourished, coming from lower socioeconomic condition of rural areas. Prolonged labor 24 (40%) was the most common cause of vesicovaginal fistula, followed by gynaecological surgeries mainly hysterectomies 18 (30%) and malignancy 4 (6.6%) rare cause. The success rate of repair following first and second attempt was 92% and 8% respectively. Overall success rate was 48 (96%) and functionally failed with a failure in 2(4%) cases. This study showed main cause for developing fistula showing prolonged labor and majority of patient were treated pervaginally. Most of the cases (96%) had successful repair which is very encouraging and correlates well with recently published series. Conclusion: Fistula can be totally preventable by proper antenatal care identification of high risk cases, timely referral, proper intranatal, postnatal care, and proper training. So improvement of health care services and dedication will prevent this type of morbidity. The best results are obtained when repair of vesicovaginal fistulae is carried out under optimal conditions”.
Objective: To determine the frequency of metabolic syndrome and its associated factors in patients with biopsy proven breast cancer at tertiary care university hospitals of Karachi, Pakistan. Methods: This cross sectional study was conducted at the hospitals affiliated with Dow university of health sciences & Baqai medical university from January 2018 to September 2019.A total of 114women between 30 to 50 years of age presented to the out patients clinics and underwent triple assessment including detailed history &examination, radiological assessment and fine needle aspiration cytology for confirmation of breast cancer were included in the study after taking written informed consent. Along with the routine baseline investigations blood sugar for hyperglycemia&blood sample for lipid profile was taken in fasting from Dow Lab. Blood pressure of the patients was also checked along with the weight, height and waist measurements. The SPSS version 19 was applied to the data for description and analysis. Results: Mean age of the patients was 42.57 ±4.90 years. Stages of cancer showed that stage III was found in majority (n=50, 43.9%). Frequency of metabolic syndrome was observed in 44 (38.6%) of the patients. A significant association of metabolic syndrome with educational status (p-value <0.001), Hypertension (p-value <0.001), Central obesity (p-value <0.001), Fasting blood sugar levels (p-value <0.001), Triglyceride levels (p-value <0.001), High density lipoprotein levels (p-value <0.001), and different Stages of breast cancer (p-value 0.003) was observed. Conclusion: This study show that a significant number of patients with breast cancer are suffering from metabolic syndrome which is also correlates with the educational status of the patients.
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