anaesthetist. A recent study has shown that epistaxis occurred significantly more frequently (44.4%) when the left nostril was used for nasotracheal tracheal intubation compared with the right nostril (11.1%). 3 We agree that fibreoptic examination of the nasal pathways could be the surest way to confirm the most patent nostril. However, this is time consuming, needs more equipment, and carries the risk of trauma if done by an untrained person.
Objective(s): To assess the association between the haematocrit value and severity of preeclampsia.Materials & Methods: This cross sectional study was conducted in the department of Obstetrics & Gynaecology of Dhaka Medical College Hospital, Dhaka during the period of January 2012 to December 2013. Total of 100 patients were studied and they were divided into two groups group-A and group-B. Fifty preeclamptic patients were included in the group-A and 50 normal pregnant women were included in the group-B.Results: Majority of preeclamptic women (68%) and normal pregnant women (76%) were in the age group of 20-30 years with the mean ages of group-A and group-B subjects were 26.50±5.71 and 26.26±4.91 years respectively. Eighty six percent of group-A and 70% of group-B women were of lower socioeconomic status. Majority of the study subjects (74% of group-A and 80% of group-B) were housewife. More than half (54%) of the preeclamptic women were primigravid and 60% of normal pregnant women were multigravid. Among the preeclamptic subjects 16 (32%) had mild hypertension (DBP<110mmHg) and 34 (68%) had severe hypertension (DBP ? 110 mmHg). Out of 50 preeclamptic subjects 45 (90%) had severe proteinuria (+++) and only 5 (10%) had moderate (++) proteinuria.The mean haematocrit value of preeclamptic patients was 34.881±3.03 and that of normal pregnant women was 31.94±1.2. It was statistically significant (P value 0.001). The mean haematocrit value of normal pregnant, mild and severe preeclamptic women were 31.94±1.2, 33.31±2.57 and 35.62±2.95 respectively. It was also statistically significant (P value 0.001).Conclusion: This study shows that haematocrit value of preeclamptic patients is significantly higher compared to that of the normal pregnant women (P<0.05). There is a strong association of increasead haematocrit and preeclampsia.Bangladesh J Obstet Gynaecol, 2015; Vol. 30(2) : 80-85
Peripartum cardiomyopathy (PPCM) is a form of dilated cardiomyopathy that can present as acute life-threatening pulmonary oedema in late pregnancy or early puerperium, its diagnosis is mainly by exclusion of other causes. Morbidity is high due to the reduced physiological reserve in pregnancy. PPCM and severe pre-eclampsia can co-exist and their clinical presentation may overlap, making the diagnosis more difficult and often delayed, with potentially devastating consequences. Here, we would like to share our experience of such a case and present to the readers how we dealt with the challenge. As obstetricians we often do not resort to transthoracic echocardiography, which in our case prompted the diagnosis timely. Lateral thinking and a heightened suspicion does help. Proper diagnosis is extremely important not only for the immediate appropriate management but also for advising long-term lifestyle modifications to minimize risk and counselling for future pregnancy.
Vesicovaginal fistula (VVF) has huge physical, psychological and, above all, social implications in a woman's life. It has always been a challenge for the urogynaecologic surgeons to manage VVF. VVF can be caused by unrelieved obstructed labour, pelvic surgery, malignancies, radiation therapy, infection and trauma. Here we report a case of VVF caused by the application of a mixture of chemicals in a female with longstanding pelvic organ prolapse. This occurrence is unique by virtue of aetiology and to the best of our knowledge is only the second of its kind reported till date. We have also explained the operative technique used to combine both the prolapse and the fistula repair into a single operation that achieved excellent functional results.
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