Incomplete miscarriage during the first trimester: a comparison of indoor versus outdoor procedure

Introduction: Miscarriage is defined as the natural death of a fetus inside the uterus. To remove complete conception material after a miscarriage, vacuum aspiration or dilatation & curettage are methods to remove uterine contents. Controversies exist regarding both procedures. So we conducted this study to confirm the more successful method. Objective: To compare the effectiveness of manual vacuum aspiration versus traditional evacuation and curettage (E & C) among females presenting with incomplete miscarriage during the first trimester of pregnancy Materials and Methods: This randomized controlled trial was done at the Department of Obstetrics & Gynecology, Shalamar Hospital, Lahore for 6 months. Then the selected females were divided randomly into 2 equal groups. In group A, females had manual vacuum procedure while in group B, females had evacuation & curettage under general anesthesia. After 12 hours of the procedure, ultrasonography was done to confirm complete evacuation. Results: The mean age of the patients was 29.87 ± 6.71 years, the mean gestational age was 8.06 ± 2.82 weeks. The effectiveness was noted in 248 (91.85%) patients. Statistically, manual vacuum showed significantly more effective as compared to evacuation & curettage procedure in the management of incomplete miscarriage i.e. p-value = 0.008. Conclusion: It has been proved that manual vacuum aspiration is more effective than traditional evacuation & curettage in the management of incomplete miscarriage

Effect of sorbic acid and some other food preservatives on human serum cholinesterase activity

The effect of some selected food preservatives on serum cholinesterase was determined. It was found that potassium metabisulphite, methyl parabene and propyl parabene caused a significant increase while sacharine, benzoic acid, salicylic acid, copper carbonate and sorbic acid caused a significant decrease in cholinesterase activity. The behavior of serum cholinesterase activity in response to a gradual change in the incubation time as well as the sorbic acid concentration was also studied. The graphical and statistical analysis of the data showed an exponential decrease in cholinesterase activity with an increase in the concentration of sorbic acid. The cholinesterase activity was also found to be decreased exponentially with an increase in the incubation time. The regression analysis showed a good agreement between the experimental and calculated values.Keywords: Sorbic acid, enzyme activity, cholinesterase, inhibition sensitivit

To determine the frequency of Group B Streptococcal colonization of vagina in women at 35-37 week pregnancy

BACKGROUND: Group B streptococci (GBS) is the usually present in vaginal canal in micro-flora, which usually do not exhibit any symptoms. Instead, in pregnancy, there are certain situations in GBS colonization in vagina, which may lead to several complications. OBJECTIVE: To determine the frequency of Group B Streptococcal colonization of vagina in women at 35-37 week pregnancy. STUDY DESIGN: Cross sectional survey SETTING: Antenatal clinic, Shalamar Hospital Lahore STUDY DURATION: 6 month i.e. From: 05-09-2014 to 06-03-2015 SUBJECTS & METHODS: 350 Booked Patients attending antenatal clinic at Shalamar hospital at 35-37 weeks of pregnancy for routine antenatal checkup were included. Lower vaginal swabs were taken without speculum using sterilized disposable cotton swab and transported to Amies Agar jell and transported to microbiology lab within 24 hours. Laboratory report was collected and reviewed by researcher regarding positive or negative culture for GBS. Patients with positive GBS culture were given intrapartum antibiotics. RESULTS: In our study, out of 350 cases, with the mean age of 26.92+4.84 years. Frequency of GBS colonization of vagina in women at 35-37 week pregnancy was recorded in 12.29% while remaining 87.71% had no findings of the morbidity. CONCLUSION: It was concluded that the frequency of GBS colonization of vagina in women at 35-37 week pregnancy is not very higher and in accordance with other regions of our country, but routine screening may further decline its incidence. KEYWORDS: Pregnancy, last trimester, Group B Streptococcal colonization of vagin

To determine the frequency of Group B Streptococcal colonization of vagina in women at 35-37 week pregnancy

BACKGROUND: Group B streptococci (GBS) is the usually present in vaginal canal in micro-flora, which usually do not exhibit any symptoms. Instead, in pregnancy, there are certain situations in GBS colonization in vagina, which may lead to several complications. OBJECTIVE: To determine the frequency of Group B Streptococcal colonization of vagina in women at 35-37 week pregnancy. STUDY DESIGN: Cross sectional survey SETTING: Antenatal clinic, Shalamar Hospital Lahore STUDY DURATION: 6 month i.e. From: 05-09-2014 to 06-03-2015 SUBJECTS & METHODS: 350 Booked Patients attending antenatal clinic at Shalamar hospital at 35-37 weeks of pregnancy for routine antenatal checkup were included. Lower vaginal swabs were taken without speculum using sterilized disposable cotton swab and transported to Amies Agar jell and transported to microbiology lab within 24 hours. Laboratory report was collected and reviewed by researcher regarding positive or negative culture for GBS. Patients with positive GBS culture were given intrapartum antibiotics. RESULTS: In our study, out of 350 cases, with the mean age of 26.92+4.84 years. Frequency of GBS colonization of vagina in women at 35-37 week pregnancy was recorded in 12.29% while remaining 87.71% had no findings of the morbidity. CONCLUSION: It was concluded that the frequency of GBS colonization of vagina in women at 35-37 week pregnancy is not very higher and in accordance with other regions of our country, but routine screening may further decline its incidence. KEYWORDS: Pregnancy, last trimester, Group B Streptococcal colonization of vagin

Comparison of neonatal respiratory morbidity in neonates delivered at term by elective caesarean section with and without antenatal Corticosteroid

Introduction:Performing elective caesarean section prior to 39 completed weeks,it can lead to breathing problems in neonates as compare to those, who are born through caesarean section without antenatal Corticosteroid. WHO recommends the administration of intramuscular corticosteroids either dexamethasone or betamethason (total 24mg in divided doses) in the antenatal period, when there is a risk of preterm birth. The advantages and disadvantages of a similar regimen given after 37 weeksof pregnancy prior to elective caesarean section (LSCS) to prevent respiratory morbidity in a newborn is yet a topic of discussion.In Pakistan still,many clinicians are doing caesarean section at 37 or 38 weeks without antenatal Corticosteroids. The rationale is to emphasize the use of steroidsbefore caesareanat 39 weeks. Objective:To compare neonatal respiratory distress in neonates delivered between 37 --38+6 weeks of gestation by elective caesarean section with and without antenatal Corticosteroid. Study design:Randomized controlled trial. Setting:Department of Gynae & Obstetrics, unit 2, Shalamar Hospital, Lahore. Duration:Six months from 12th September 2018 to 12th March 2019. Materials and Methods:The study included women who were, planned for elective LSCS at 37-38+6 weeks, divided into two groups .The sample size was 140 (70 in each group),recruited by non-probability consécutive sampling. Inclusion criteria were singleton pregnancy, at 37 to 38+6 weeks for elective LSCS due to indications like primi breech, previous caesarian scar/scars, and maternal wish. All eligible participants were allocated to one of the following groups. Group (A) received an injection of dexamethasone 48 to 72 hours before elective LSCS. Group (B), did not receive an injection of dexamethasone. The outcome to be measuredinthis study were the Apgar score at 1& 5 minutes, the incidence of transient tachpnea of the neonate (TTN) and respiratory distress syndrome (RDS) in newborns,and the need for mechanical ventilation among neonates from two different groups. The data was collected and analyzed by SPSS version 20.Descriptive statistic were applied to calculate the mean and SD for age, gestation age & BMI. Student T-test was used to compare the continuous outcome measures. Neonatal respiratory morbidity was compared in two groups by using the chi-square test at the level of significance of 0.05.Results:Mean age in Group-A was 28.12± 5.6 and in Group-B was 28.97± 6.3 years. There was no statistically significant difference in these groups in termsof Body mass index, gestational age at the time of delivery, age of mother, birth weight, Apgar score at 1 and 5 min,and indications for cesarean section. Neonatal respiratory morbidity was higher in Group-B as compared to Group-A (30% vs.12.9%)p-value-0.013. Conclusion:Antenatal dexamethasone administration significantly reduces the respiratory morbidity among neonates delivered at 37 to 38+6by elective cesarean section. But further studies are required to assess the beneficial role of dexamethasone in the reduction of neonatal respiratory morbidity with a large sample size.Keywords:Neonatal respiratory morbidity, transient tachypnea of newborn, elective caesarean section, antenatal corticosteroids