Hysterectomy is one of the most frequently performed gynecological procedure all over the globe undertaken for varying indications, to effectively cure many gynaecological conditions. Histopathological analysis of the hysterectomy specimens should be undertaken for justification of procedure and diagnostic purposes. Objectives: To determine the frequency and morphology of different benign histopathological lesions in total abdominal hysterectomy specimens. Study Design: Descriptive cross-sectional study. Setting: Department of Pathology Fatima Jinnah Medical College. Period: From Jan 2015 to June 2015. Material & Methods: The gross and histopathological findings of uterus and cervix in one hundred Total Abdominal hysterectomy specimens were studied. Non-probability, purposive sampling was done. Total abdominal hysterectomy specimens with or without salpingoophorectomy of patients aged between 20 to 70 years were included. While Total abdominal hysterectomy done in mentally retarded patients and for malignancies were excluded. Patient’s data, presenting complaints and preoperative diagnosis was recorded on predesigned proforma. SPSS version 17 was used as an analytical tool. Results: Age of the patients ranged from 30-55 years with 72% between 41-50 years. The microscopic examination of the cervix revealed features of chronic cervicitis in 75% cases. The commonest neoplastic lesion was leiomyoma present in 66% of cases. Myometrium revealed foci of adenomyosis in 21% cases. Endometrial histology showed hyperplasia in 25% of cases(simple hyperplasia 20%, cystic hyperplasia 4% and complex hyperplasia 1%), hormonal imbalance in 21%, pressure atrophy in 11%, atrophic endometrium in 6% , cystic atrophy in 2% while acute and chronic endometritis in 1% and 2% of cases respectively. Conclusion: The commonest cervical lesion was chronic cervicitis (75%). The commonest benign neoplastic lesion was leiomyoma, present in 66% of cases. Other common pathologies on histology were hyperplasia in 25% of cases, adenomyosis and hormonal imbalance in 21 % of cases each, pressure atrophy in 11%, atrophic endometrium in 6% while endometritis (acute & chronic ) in 3% of cases mainly. Histopathological examination of hysterectomy specimens helps to detect the exact cause and underlined pathology.
Objective: To compare the safety, efficacy and complications of manual vacuum aspiration (MVA ) versus surgical evacuation in low resource set up. Study Design and Setting: This crossectional study conducted at Department of Obstetrics & Gynaecology at Kulsoom Bai Valika Social Security SITE Hospital Karachi from January to June 2017. Methodology: A total of one hundred patients with less than 12 weeks of gestation and diagnosis of missed miscarriage, incomplete miscarriage, blighted ovum or with retained products of conception (RPOCs) were recruited and randomly allocated to MVA without anesthesia (Group A) and surgical evacuation under general Anesthesia in Operation theatre (Group B).Both groups were compared in terms of demographic and obstetric data, clinical course (need of anaesthesia, operating time, approximate blood loss and stay in hospital) ,complications(excessive bleeding, uterine perforation, need for re-evacuation/ failed procedure, sepsis and maternal death ) and patient satisfaction. Results: Mean age of patients was 28.68 in Group A and 26.90 in Group B ( P value-0.136). Average gestational age in weeks at which procedure was performed in Group A found to be 8.32 and 9.546 for Group B ( P value-0.007 ). Parity was comparable in both groups (P value-0.746). Most of the patients were literate. Mean operating time and amount of blood loss comparison among groups had no statistical difference. Average hospital stay was significantly short in MVA Group ( P value-0.001). No maternal death or uterine perforation observed in both the groups,6% and 8% of patients had excessive bleeding in Group A & Group B respectively, one patient underwent re-evacuation in MVA group and one had sepsis after surgical evacuation. Post procedure satisfaction was comparable in both the groups. Conclusion: Manual Vacuum Aspiration is comparable to surgical evacuation in terms of safety, efficacy, complications, patient satisfaction and superior in shorter hospital stay, no need of anesthesia and access to operation theater
Background and Aim: In the past decades the rate of cesarean sections has increased enormously, there are many indications for cesarean section like placenta previa, labor dystocia, presumed fetal distress, fetal malpresentation, multiple gestation, and suspected fetal macrosomia, but the commonest reason for performing a cesarean is a previous cesarean birth .The present study aimed to compare the sonographically measured lower uterine scar with actual status of scar at the time of operation. Methodology: The descriptive cross-sectional study was conducted on 150 female patients who presented to Obstetrics department of Creek general hospital, affiliated with UMDC from August 2021 to January 2022. The Inclusion Criteria was: females with singleton pregnancy with history of previous single caesarian section, vertex presentation and gestational age 36-40 weeks. While women with multiple gestations, placenta previa, polyhydramnios or any uterine abnormality were excluded. Results: The overall mean of age, gestational age, parity and fetal weight were 28.22±4.59 years, 37.60±0.78 weeks, 1.73±0.94 and 2.75± 0.47 kg respectively. Significant association was observed between lower uterine segment measurements by Sonographic scar thickness during pregnancy and intra-operative scar findings at the time of delivery (p-value< 0.05). Conclusion: The present study found that sonographically measured lower uterine scar thickness is a solid predictor for scar defect in women with previous cesarean section. As a result, we can conclude that sonographic measurement of lower uterine segment thickness is a reliable tool for assessing scar status and deciding which women should be given a vaginal delivery trial. Keywords: Previous Caesarean Section, Lower uterine scar, Sonography
Low birth weight is a key determinant of infant survival, health and development. Low birth weight infants are at a greater risk of morbidity and mortality than an infant of normal birth weight and create a substantial strain on the healthcare system. Objectives: To determine the frequency of low birth weight at term and maternal contributing risk factors in women attending antenatal clinic at Creek General Hospital Korangi, Karachi. Study Design: Descriptive cross sectional study. Setting: Department of Obstetrics and Gynecology of Creek General Hospital, United Medical and Dental College Karachi. Period: From May 2017 to April 2018. Material & Methods: Those women who gave birth to babies with less than 2500gm at term, were included in the study to ascertain the frequency and risk factors of low birth weight including age, parity, booking status for antenatal care, pre-pregnancy BMI, history of tobacco intake, medical disorders arising in pregnancy like anemia, pregnancy induced hypertension and gestational diabetes mellitus, birth weight and fetal gender. The data was analyzed on SPSS software. Results: The prevalence of term low birth weight was 22%. Percentage of low birth weight babies among teenage mothers was 72.8%, among the studied mothers 67.4% were primipara, 91.5% had standard antenatal care, Pre-pregnancy BMI was found to be normal in 93% of mothers, 9 mothers (7%) had history of tobacco/ betel nut chewing habit. In this study, iron deficiency anemia was found to be most significant factor leading to LBW babies (62 %). 12% and 8% of mothers were diagnosed with Pregnancy induced Hypertension and Gestational Diabetes mellitus respectively. Regarding fetal gender, 68 were females (52.7%) and 61 (47.3%) were males. Conclusion: Low Birth Weight is an important contributing risk factor for perinatal mortality and morbidity in Pakistan. Anemia was found to be most significant risk factor leading to Low birth weight in our study.
OBJECTIVE: To explore the perception of undergraduate students of United Medical and dental college towards objective structured clinical examination as an assessment tool. MATERIAL & METHODS: A cross-sectional observational study included undergraduate medical students, RESULTS: 153 students who completely filled the proforma were included in study among them 31% were male and 69% were females. Mostly agreed that stations in OSCE were simple and easily interpretable and assessed practical skills thoroughly. Majority of students accepted that skills inquired were taught in clinics, stations were according to course and stations were appropriately timed. 66 % confirmed that adequate instructions were provided before exam. 84.31% believed that OSCE is preferable to viva. 57.51% of candidates stated that examiners during OSCE were attentive and gracious but 20.91 % objected it , while 21.57% remained neutral. Almost half of examinees labelled it as comprehensive clinical assessment .Overall, 67.97 % perceived OSCE as demanding and tough assessment. Finally views of students for statement that OSCE is unbiased, reliable and valid were positive in 50.32%.There was a significant difference in the opinion of male and female( p-value is less than 0.05) in statement that OSCE thoroughly assessed practical skills, stations were according to course of instruction, Adequate instructions were provided before exam, superior and preferable to viva, assists in improvement of clinical skills, demanding and tough and finally OSCE was unbiased, reliable and valid CONCLUSION: OSCE was perceived as fair, comprehensive, un-biased format of examination but believed it was more stressful than traditional examination methods . KEY WORDS: Assessment, Attitude, OSCE, Perception, Undergraduate Medical students.
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