Study of Postdatism with Respect to Fetomaternal Outcome at A Tertiary Care Hospital

OBJECTIVES This study aims to know our setup’s fetomaternal pregnancy complications that extend beyond 40 weeks of gestation. METHODOLOGY This is a prospective cross-sectional study of 390 patients with uncomplicated postdated pregnancies fulfilling the inclusion and exclusion criteria admitted to the department of Obstetrics and Gynecology (both in spontaneous labour and induced patient) at Hayatabad Medical Complex, a tertiary care hospital in Peshawar, KPK from July 2020 to June 2021.RESULTS Out of 390 patients, a majority (72.30 %) were in the age group of 20 – 35 years. Most of them (50.51%) presented at gestation 40+1 – 40+6 weeks. The majority (57.69%) were multigravida, and most (93.07%) were un-booked. Most delivered vaginally (80.51%), and 19.48% had C/section (including both emergency and elective). The most common indication for C/section was fetal distress (44.73%), followed by C/section on demand (18.42%). The majority>90% had Apgar score greater than seven at 5 minutes which was gestation dependent. Overall perinatal mortality was 4.07% which was also gestation dependent ranging from 0.5% at 40+1 – 40+6 weeks to 2.30% at and beyond 42 weeks of gestation. Neonatal morbidity in the form of Birth asphyxia, Meconium Aspiration Syndrome (MAS), Shoulder Dystocia and NICU admission also showed an increasing tendency with increasing gestation beyond 40 weeks. Maternal morbidity in the form of PPH, perineal tears 3°/4° and endometritis also showed a similar increasing trend with increasing gestation beyond 40 weeks. CONCLUSION Pregnancy continuing beyond 40 weeks has a definite risk to the fetus.

Self-reported health and smoking status, and body mass index: a case-control comparison based on GEN SCRIP (GENetics of SChizophRenia In Pakistan) data

Introduction Individuals with schizophrenia are at a high risk of physical health comorbidities and premature mortality. Cardiovascular and metabolic causes are an important contributor. There are gaps in monitoring, documenting and managing these physical health comorbidities. Because of their condition, patients themselves may not be aware of these comorbidities and may not be able to follow a lifestyle that prevents and manages the complications. In many low-income and middle-income countries including Pakistan, the bulk of the burden of care for those struggling with schizophrenia falls on the families.Objectives To determine the rate of self-reported physical health disorders and risk factors, like body mass index (BMI) and smoking, associated with cardiovascular and metabolic disorders in cases of schizophrenia compared with a group of mentally healthy controls.Design A case-controlled, cross-sectional multicentre study of patients with schizophrenia in Pakistan.Settings Multiple data collection sites across the country for patients, that is, public and private psychiatric OPDs (out patient departments), specialised psychiatric care facilities, and psychiatric wards of teaching and district level hospitals. Healthy controls were enrolled from the community.Participants We report a total of 6838 participants’ data with (N 3411 (49.9%)) cases of schizophrenia compared with a group of healthy controls (N 3427 (50.1%)).Results BMI (OR 0.98 (CI 0.97 to 0.99), p=0.0025), and the rate of smoking is higher in patients with schizophrenia than in controls. Problems with vision (OR 0.13 (0.08 to 0.2), joint pain (OR 0.18 (0.07 to 0.44)) and high cholesterol (OR 0.13 (0.05 to 0.35)) have higher reported prevalence in controls. The cases describe more physical health disorders in the category ‘other’ (OR 4.65 (3.01 to 7.18)). This captures residual disorders not listed in the questionnaire.Conclusions Participants with schizophrenia in comparison with controls report more disorders. The access in the ‘other’ category may be a reflection of undiagnosed disorders