Objective: To study on clinical profile & maternal - fetal outcome of eclamptic patient.Methods: A prospective cross sectional study was done in the department of Obstetrics & Gynaecology in Chittagong Medical College and Hospital from January to December 2010. All patients with eclampsia were included in the study, it was 416. Patients came with convulsion other than eclampsia e.g. epilepsy, malaria, septicemia, meningitis, encephalitis, cerebral haemorrage, high fever, hepatic coma were excluded.Main outcome measures: Incidence of eclampsia, sociodemographic status, ante natal care, time interval between attack and admission, level of consciousness was assessed by AVPU(Alert, response to voice, response to pain stimuli, Unconsciousness) score, types of eclampsia patients (antepartum,intrapartum,postpartum), number of convulsion, gestational age distribution of the patients, mode of delivery , maternal and fetal outcome.Results: Total number of deliveries during this period was 13,635. The incidence of eclampsia in this study was 3.05 %. Among 416 patients with eclampsia most of the patients were between 20-25 years (77%), a large number were primi para (72.5%), most of them comes from rural area (76%), most of them belongs to poor socioeconomic condition (72%), 49% patients were illiterate, 60 % patients had no antenatal check up, 52 % patients came after 6 hours of beginning of convulsion, 18 patients (4%) were unconscious, most of the patients had antepartum eclampsia (64%) , number of convulsion was between 5-9 in about 58% case , 63% were delivered by LSCS, 23% mother showed complications of eclampsia, of them pulmonary oedema (7.45%) and renal failure(6.49%) were common, 35 (8%) mothers were died. Among perinatal mortality 18% baby were stillbirth and 9% were early neonatal death.Conclusion: Eclampsia is still a major killer disease in Bangladesh. It is a preventable disease if preeclampsia is diagnosed by antenatal care. By giving quality antenatal care, mass awareness regarding the importance of antenatal care, emergency obstetric service in the upazilla health complex we can prevent eclampsia. Female education, employment, empowerment is urgently needed to reduce the incidence of this killer diseases. DOI: http://dx.doi.org/10.3329/bjog.v26i2.13784 Bangladesh J Obstet Gynaecol, 2011; Vol. 26(2) : 77-80
Aims and objectives: The objective of this study was to determine the less post operative morbidities and better compliance of the patient following vaginal hysterectomy in case of non descent uterus.Materials and Methods: This is a cross sectional descriptive study of patients admitted in Chittagong medical college Hospital and different private clinics between May 2010 and April 2013. Total 126 patients requiring hysterectomy recruited for the study. Indications of Non-descent vaginal hysterectomy (NDVH) were dysfunctional uterine bleeding ( DUB), fibroid uterus, adenomyosis, chronic cervicitis, CIN- II and III, endomertrial hyperplasia, PID and invasive mole. NDVH were performed in cases with mobile uterus, size not exceding 14 weeks of gestation, and with adequate vaginal access. Morcellation techniques like bisection, myomectomy, wedge debulking or combination of these were employed in bigger and firmer uteri.Results: Age ranged from 35 -60 years with majority (68.25%) between 45 and 50 years and 8.70% above 50 years. Seventy nine (62.698%) women were of 3 or more parity, 38 cases (30.15%) had two and 9 cases (7.14%) had one. Preoperative uterine size varied from eight weeks size 98 (77.77%), 12 weeks size 21 cases (16.66%) and more than 12 weeks size7 cases (5.55%). Table 1 depicts the indications for NDVH. One hundred nineteen patients had hysterectomy and remaining 7 had hysterectomy with salpingo-oophorectomy. Eighty four (66.66%) operations were complete within 90 minutes and remainder needed 90 minutes to 3 hours. Average blood loss was up to 200 ml in 91 (72.20%) cases and in other cases it was more than 200 ml. Average hospital stay was 2 days in the majority (76.20%) while 3-5 days in others. Bladder injury occurred in 6 cases (4.76%) and rectum injury in 1case (0.79%) during operation. Postoperatively 12 (9.52%) patient were suffering from secondary haemorrhage and 15 (11.11%) patient from vault granuloma. Analgesic requirement was at minimum during post operative period. Cost was reduced with the compared to the other route of hysterectomy.Conclusion: NDVH is a less invasive technique with benefits,which includes shorter hospital stay and faster convalescence and avoid abdominal wound complications. It should be a primary methods for removal of large uterus provided one is familiar with morcellation technique.DOI: http://dx.doi.org/10.3329/cmoshmcj.v13i1.19411
Objective: Obesity and diabetes mellitus are interconnected conditions that share a number of pathophysiological mechanisms such as dyslipidemia leading to cardiovascular complications. The present study was conducted to determine the individual and combined effect of diabetes mellitus and obesity on dyslipidemia and ultimately on silent coronary artery disease (CAD). Methods:The patients selected from urban and rural areas of Lahore were recruited on the basis of body mass index (BMI) and fasting blood sugar (FBS) and were classified in four groups: (Group A; obese-diabetic, Group B; non-obese and diabetic, Group C; obese and non-diabetic and Group D; non-obese and non-diabetic).Total lipid profile including total cholesterol, triglycerides, high density lipoproteins and low density lipoproteins were determined along with exercise tolerance test (ETT). Results:The results indicated that combined obesity and diabetes was the major cause of Dyslipaedemia and CAD followed by obesity and diabetes alone. Triglycerides and atherogenic level of HDL-C were more prevalent in obese-diabetic patients (group A) followed by obese (group C) and diabetic (group B) alone.However low density lipoprotein (LDL) was more significant in obese (group C) but the results were also comparable in all other groups. Conclusion:The result of ETT revealed that overall group A was more prone towards CAD as compared to group B and group C but there was a non-significant correlation between CAD and obesity/diabetes within all experimental groups. Moreover, the risk of dyslipidemia and CAD was non significantly higher in urban population than rural population.
doi: 10.3329/jcmcta.v18i1.3812Journal of Chittagong Medical College Teachers' Association 2007: 18(1):6-8
A pilot maternal and child health and family planning service project in urban and rural areas of Lahore, Pakistan, was evaluated after 4 years (1984-1988). In this time the birth rate declined from 41.0 to 19.2, infant mortality from 119.0 to 70.2, and maternal mortality from 560 to 220 per 100,000 live births. Success was attributed to medical audit of services through peer review of performance.
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