ASSOCIATION OF SHORT INTERPREGNANCY INTERVAL (IPI) WITH MATERNAL ANEMIA AT A TERTIARY CARE HOSPITAL

Background; The time interval between pregnancies is considered to be an important and modifiable risk factor in terms of adverse perinatal outcomes. This study was done to  determine the frequency of anemia in pregnant women having short interpregnancy interval. Materials and methods; All the pregnant women with short interpregnancy interval were registered from Department of Gynecology and Obstetrics, Nishtar Hospital Multan, Pakistan. Examination was done including general physical examination. Those with interpregnancy interval less than 6 months were included in study. Detailed history was taken regarding parity, duration of pregnancy. Duration of gestation was estimated according to patients last menstrual period. Three ml venous blood sample was drawn and sent to the pathology laboratory of Nishtar Hospital Multan for Hb levels analysis. Data was entered and analyzed by SPSS version 20. Results; Mean age of our study cases was noted to be 27.83 ± 4.95 years (with minimum age of our study cases was 21 years while maximum age was noted to be 38 years). Of these 90 study cases, 51 (56.7%) were from rural areas, 73 (81.1%) were normal weight 11(12.2%) were overweight and 6 (6.7%) were obese. Seventy eight (86.7%) were illiterate. Of these 90 study cases, 73 (81.1%) were having poor socioeconomic status, 11 (12.2%) were diabetic and 17 (18.9%) were hypertensive. Mean body mass index (BMI) of our study cases was noted to be 22.31 ± 2.07 Kg/m2. Mean gestational age of our study cases was noted to be 24.02 ± 8.31 weeks. Mean Hb level was noted to 10.67 ± 0.893 g/dl (with minimum Hb level was 9.6 g/dl while maximum Hb level was 12.5 g/dl). Mean interpregnancy interval was 4.23 ± 0.98 months (with minimum interpregnancy interval was 2.5 months while maximum interpregnancy interval was 6 months). Anemia was noted in 74 (82.2%) our study cases and only 23 (25.6%) of our study cases were taking iron supplements. Conclusion; Short interpregnancy interval less than 6 months is related with adverse pregnancy outcomes. Very high frequency of anemia was noted in our study cases having interpregnancy interval less than 6 months. Anemia was significantly associated with residential status, hypertension and iron supplementation. Birth spacing is an issue which women should have some control over. Educational interventions, including birth control, should be applied during prenatal visits and following delivery. Keywords; Short interpregnancy Interval, anemia, hemoglobin

ROLE OF PROSTAGLANDIN E2 FOR INDUCTION OF LABOR IN PATIENTS WITH PREMATURE RUPTURE OF MEMBRANES AT TERM.

Background; As the time between the rupture of the membranes and the onset of labor increases, so may the risk of maternal and fetal infection so this study was conducted to ascertain the role of prostaglandin E2 for induction of labor in patients with PROM at term.  Material and Methods; All the study cases (n = 161) presenting with premature rupture of membranes (PROM) having singleton were taken from Department of Gynecology and Obstetrics, Nishtar Hospital Multan in this descriptive case series. Pregnant women were examined in lithotomy position, leakage of fluid was inspected by sterile speculum.  Three mg of Prostaglandin E2 was kept in posterior fornix and women were kept in left lateral position for 30 minutes. If the uterine activity does not start and Bishop score remains unchanged (≤6), same dose was repeated after 6 hours. Data was analyzed by using SPSS Version 20. Results; Mean age of our study cases was 28.74 ± 5.03 years (with minimum age was 21 years while maximum age was 39 years). Our study results have indicated that majority of our study cases i.e. 112 (69.6%) were aged 20 – 30 years of age. Of these 161 study cases, 70 (43.5%) were from rural areas while 91 (56.5%) were from urban areas. Mean parity of our study 3.17 ± 0.81 and most of the study cases i.e. 105 (65.2%) had parity up to 3. Mean gravidity was 4.35 ± 0.81 and most of the study cases i.e. 91 (56.5%) had gravidity up to 4. Mean body mass index (BMI) was noted to be 24.21 ± 3.08 kg/m2 and obesity was noted in 28 (17.4%) of our study cases. Mean duration of hospitalization before delivery was noted to be 14.15 ± 4.67 hours while time taken for induction of labor was 4.24 ± 1.36 hours and mean gestational age was noted to be 39.43 ± 1.17 weeks. Cesarean section was noted in 31 (19.3%) of our study cases while 130 (80.7 %) underwent vaginal deliveries and poor APGAR score was noted in 11 (6.8%). Conclusion; Our study results support the use of prostaglandin E2 for induction of labor in women with premature rupture of membranes at term as it was safe, reliable and effective mode of treatment. No major side effects were noted in our study. Mode of delivery and poor APGAR score were significantly associated with parity, gravidity, obesity and prolonged duration of hospitalization. Keywords; Premature rupture of membrane, term, prostaglandin

Sonographic Evaluation of Cholelithiasis and Its Correlation with Normal/Fatty Liver

Cholelithiasis and Fatty Liver disease are usually observed to coexist. Patients who have gallstones also have Fatty Liver as both of the conditions have same associated risk factors I.e., diabetes mellitus, gender, age, obesity, metabolic syndrome, insulin resistance and high lipids level. Non-Alcoholic Fatty Liver Disease (NAFLD) is also an independent accountable risk factor for the formation of gallstones. We aimed to determine whether there is any correlation between cholelithiasis and fatty liver disease. The study was conducted in Lahore General Hospital, Lahore, Pakistan. The data was collected from March 24,2021 to May 24,2021. Informed consent was taken from all the participants. We did a cohort study comprising the data of 51 patients undergoing physical checkup. The data gathered included age, gender and whether they had normal or fatty liver. Cholelithiasis was diagnosed by confirming the presence of gallstones on abdominal ultrasonography after fasting for approximately 8hrs. it was an observational study for the assessment of correlation between cholelithiasis and fatty liver in the participants. A Total of 51 patients with cholelithiasis were included in our study. Most of the patients were 29 to 70 years of age. The average age of the patients was 42.3 ± 10.1 years. Out of 51 patients, there were 60.8% (P=31) females and 39.2%(P=20) males. Out of 51 cholelithiasis patients there were 31.4%(P=16) had Normal Liver and 68.6%(P=35) were positive with Fatty liver disease. Patients with stone size ranges from 1.90mm to 4.6mm hade Grade 1 Fatty liver as shown in table-5.4, Grade 2 Fatty liver was seen in patients with stone size ranges from 4.5mm to 5.8mm. Fatty liver Grade 3 was not observed in any included patient with cholelithiasis. Results of our study showed that both cholelithiasis and Fatty Liver disease are correlated with each other. Females are at higher risk to be affected by these with diseases. Early detection of Fatty liver in patients of cholelithiasis can help patients to prevent them further complications regarded to fatty liver and cholelithiasis and can play important role in health care of society. Keywords: Non-Alcoholic Fatty Liver Disease, Cholelithiasis, Fatty liver, Ultrasonography. DOI: 10.7176/JHMN/91-07 Publication date:July 31st 202

University of Calgary - Zoology 435 Insect Survey Report

Students enrolled in Zoology 435 – Entomology, during fall term 2020 conducted a biodiversity survey of insects in the City of Calgary and their backyards in a variety of localities. Students collected insects where permits and permissions were available, and took digital observations for the iNaturalist platform from all localities