Journal of Ayub Medical College, Abbottabad : JAMC
Menorrhagia is objectively defined as blood loss greater than 80 ml or menstrual period lasting l... more Menorrhagia is objectively defined as blood loss greater than 80 ml or menstrual period lasting longer than 7 days. Dysfunctional uterine bleeding is responsible for 80% cases of Menorrhagia. Objective of this study was to find out the endometrial pathology and usefulness of hysterocopic directed endomentrial sampling in patient having menorrhagia in premenopausal age group. This prospective descriptive study was conducted at Unit 1 of the Department of Obstetrics and Gynaecology, Fauji Foundation Hospital Rawalpindi, Pakistan from January to December 2007. During the study period, 100 patients with menorrhagia in age group 35-50 years were selected after fulfilling the inclusion criteria. These patients were selected from Gynaecology out patient department. After detailed history, examination and ultra sonography, they were admitted and hysteroscopic directed endometrial sampling was done endometrial samples were sent for histopathology to find out the endometrial pathology. The se...
Journal of Ayub Medical College, Abbottabad : JAMC
To study the methods used for the termination of pregnancy and associated complications of induce... more To study the methods used for the termination of pregnancy and associated complications of induced abortion. This descriptive study was conducted in the department of obstetrics and gynaecology, Fauji Foundation Hospital Rawalpindi. One Hundred patients were included in the study who was admitted with the history of induced abortion. The patients were assessed by detailed history and thorough clinical examination according to the study protocol. Data was collected on a specially designed Performa. Patients were interviewed in privacy and factors contributing to termination of pregnancy like age, parity, socioeconomic status and contraceptive failure were determined. Methods used for the procedure, status of abortionist were asked. Complications were determined by history, clinical examination and ultrasound examination. In view of all above data recommendations of preventing unwanted pregnancies were made. All patients were married and 57% of women belonged to age group of 31-40 yea...
Journal of Ayub Medical College, Abbottabad : JAMC
Postmenopausal bleeding (PMB) is bleeding occurring after 6-12 months of amenorrhea in a woman of... more Postmenopausal bleeding (PMB) is bleeding occurring after 6-12 months of amenorrhea in a woman of age where the menopause can be expected. Objectives of this study were to ascertain various causes and prevalence of genital organ malignancy in patients presenting with postmenopausal bleeding. A prospective observational study carried out in the Department of Obstetrics and Gynaecology, Fauji Foundation Hospital, Rawalpindi comprising of 167 consecutive cases presenting with postmenopausal bleeding one year after menopause. Women having undergone hysterectomy and bilateral salpingo-oophorectomy, receiving radiotherapy or chemotherapy, suffered trauma to the genital tract, having coagulation disorder or on anticoagulant or hormone replacement therapy were excluded. Detailed history was obtained and a thorough clinical examination was conducted. Data were entered into hospital computer database (Medix) system. Mean +/- SD were calculated for age, percentage was calculated for types of h...
Journal of Ayub Medical College, Abbottabad : JAMC, 2009
BACKGROUND Abdominal and vaginal hysterectomies are the two predominant operative modalities for ... more BACKGROUND Abdominal and vaginal hysterectomies are the two predominant operative modalities for various uterine conditions; however the indications for selecting a particular procedure in any setting may not be optimally defined. This study was undertaken to evaluate the appropriate route of hysterectomy (abdominal or vaginal) in a hospital population for women with benign disease by comparing peri-operative and post-operative complications. METHODOLOGY This quasi-experimental study was undertaken at the Department of Obstetrics and Gynaecology, Fauji Foundation Hospital/Foundation University Medical College, Rawalpindi from January to December 2007. Eighty subjects were equally divided into vaginal and abdominal hysterectomy groups by convenience (non-probability) sampling. The primary outcome measures were operative time, primary haemorrhage, wound infection, post-operative analgesia, febrile morbidity, hospital stay and secondary haemorrhage; secondary outcome measure were estim...
Uterine myomas are common but erythrocytosis caused by these is rarely seen. We report a case tha... more Uterine myomas are common but erythrocytosis caused by these is rarely seen. We report a case that illustrates the conjunction of various aetiological factors required for this clinical entity to evolve. A voluminous, retroperitoneally located and focally degenerated myoma was associated with severe secondary erythrocytosis (haematocrit: 65.5%) which resolved after hysterectomy. It has been demonstrated previously that myomatous tissue is the source of excessive production of erythropoietin. Local tissue hypoxia, which is more prone to develop in a pedunculated myoma, stimulates the process. Other prerequisites are a very large size of the myoma and the absence of menometrorrhagia of a severity such as to cause a depletion in iron reserves.
To compare outcomes of vaginal and abdominal hysterectomy procedures in women with benign gynaeco... more To compare outcomes of vaginal and abdominal hysterectomy procedures in women with benign gynaecological diseases. This was a prospective study of outcomes of consecutive patients who underwent total vaginal hysterectomy (VH) or abdominal hysterectomy (AH) for benign gynaecological diseases. Patient characteristics before, during, and after the operations were reviewed. Patients were followed up for three months to evaluate postoperative complications. This study included a total of 313 patients. 143 patients underwent AH and 170 patients underwent VH. Baseline characteristics were similar between the two groups. There were no intraoperative complications in either group. Operation time, intraoperative blood loss, first postoperative flatus time, time to out-of-bed activity, mean maximum postoperative body temperature, and duration of fever were all significantly shorter and less severe in the VH group compared with the AH group. In addition, vaginal length in the VH group was signi...
Journal of Ayub Medical College Abbottabad Jamc, 2010
Background: At least 20% of all women and 40% of women over the age of 40 years have uterine leio... more Background: At least 20% of all women and 40% of women over the age of 40 years have uterine leiomyomas. They distort the overlying endometrium and can become extruded or pedunculated (fibroid polyp) in the endometrial canal. The diagnosis of myomas is usually based upon the finding of an enlarged, mobile uterus with an irregular contour on bimanual examination or an incidental finding on transabdominal sonography. The objective of this study was to study the frequency of fibroid uterus in multipara women as observed by physical examination and ultrasonography. Methods: During this descriptive study period all the patients reporting Fauji Foundation Hospital with menstrual irregularity partly and fulfilling the inclusion criteria were included. Results: Out of 140 patients with fibroid uterus presenting to gynaecology department 108 (77.14%) were multiparous while 32 (22.86%) were primiparous. The mean parity was 5. The mean maternal age came to be 46 years. Most common presenting complaint of patients with uterine leiomyoma in this study was menstrual irregularity with menorrhagia in 42 (38.9%), metrorrhagia in 28 (25.9%), polymenorrhagia in 8 (7.4%) patients. The other presenting complaint was abdominal mass which was seen in 25 (23.1%). Conclusion: Multiparous patients were found to have fibroids more frequently than nulliparous in their perimenopausal years, which shows their characteristic slow growth rate. The most common manifestation was menorrhagia.
Journal of Ayub Medical College, Abbottabad : JAMC
Menorrhagia is objectively defined as blood loss greater than 80 ml or menstrual period lasting l... more Menorrhagia is objectively defined as blood loss greater than 80 ml or menstrual period lasting longer than 7 days. Dysfunctional uterine bleeding is responsible for 80% cases of Menorrhagia. Objective of this study was to find out the endometrial pathology and usefulness of hysterocopic directed endomentrial sampling in patient having menorrhagia in premenopausal age group. This prospective descriptive study was conducted at Unit 1 of the Department of Obstetrics and Gynaecology, Fauji Foundation Hospital Rawalpindi, Pakistan from January to December 2007. During the study period, 100 patients with menorrhagia in age group 35-50 years were selected after fulfilling the inclusion criteria. These patients were selected from Gynaecology out patient department. After detailed history, examination and ultra sonography, they were admitted and hysteroscopic directed endometrial sampling was done endometrial samples were sent for histopathology to find out the endometrial pathology. The se...
Journal of Ayub Medical College, Abbottabad : JAMC
To study the methods used for the termination of pregnancy and associated complications of induce... more To study the methods used for the termination of pregnancy and associated complications of induced abortion. This descriptive study was conducted in the department of obstetrics and gynaecology, Fauji Foundation Hospital Rawalpindi. One Hundred patients were included in the study who was admitted with the history of induced abortion. The patients were assessed by detailed history and thorough clinical examination according to the study protocol. Data was collected on a specially designed Performa. Patients were interviewed in privacy and factors contributing to termination of pregnancy like age, parity, socioeconomic status and contraceptive failure were determined. Methods used for the procedure, status of abortionist were asked. Complications were determined by history, clinical examination and ultrasound examination. In view of all above data recommendations of preventing unwanted pregnancies were made. All patients were married and 57% of women belonged to age group of 31-40 yea...
Journal of Ayub Medical College, Abbottabad : JAMC
Postmenopausal bleeding (PMB) is bleeding occurring after 6-12 months of amenorrhea in a woman of... more Postmenopausal bleeding (PMB) is bleeding occurring after 6-12 months of amenorrhea in a woman of age where the menopause can be expected. Objectives of this study were to ascertain various causes and prevalence of genital organ malignancy in patients presenting with postmenopausal bleeding. A prospective observational study carried out in the Department of Obstetrics and Gynaecology, Fauji Foundation Hospital, Rawalpindi comprising of 167 consecutive cases presenting with postmenopausal bleeding one year after menopause. Women having undergone hysterectomy and bilateral salpingo-oophorectomy, receiving radiotherapy or chemotherapy, suffered trauma to the genital tract, having coagulation disorder or on anticoagulant or hormone replacement therapy were excluded. Detailed history was obtained and a thorough clinical examination was conducted. Data were entered into hospital computer database (Medix) system. Mean +/- SD were calculated for age, percentage was calculated for types of h...
Journal of Ayub Medical College, Abbottabad : JAMC, 2009
BACKGROUND Abdominal and vaginal hysterectomies are the two predominant operative modalities for ... more BACKGROUND Abdominal and vaginal hysterectomies are the two predominant operative modalities for various uterine conditions; however the indications for selecting a particular procedure in any setting may not be optimally defined. This study was undertaken to evaluate the appropriate route of hysterectomy (abdominal or vaginal) in a hospital population for women with benign disease by comparing peri-operative and post-operative complications. METHODOLOGY This quasi-experimental study was undertaken at the Department of Obstetrics and Gynaecology, Fauji Foundation Hospital/Foundation University Medical College, Rawalpindi from January to December 2007. Eighty subjects were equally divided into vaginal and abdominal hysterectomy groups by convenience (non-probability) sampling. The primary outcome measures were operative time, primary haemorrhage, wound infection, post-operative analgesia, febrile morbidity, hospital stay and secondary haemorrhage; secondary outcome measure were estim...
Uterine myomas are common but erythrocytosis caused by these is rarely seen. We report a case tha... more Uterine myomas are common but erythrocytosis caused by these is rarely seen. We report a case that illustrates the conjunction of various aetiological factors required for this clinical entity to evolve. A voluminous, retroperitoneally located and focally degenerated myoma was associated with severe secondary erythrocytosis (haematocrit: 65.5%) which resolved after hysterectomy. It has been demonstrated previously that myomatous tissue is the source of excessive production of erythropoietin. Local tissue hypoxia, which is more prone to develop in a pedunculated myoma, stimulates the process. Other prerequisites are a very large size of the myoma and the absence of menometrorrhagia of a severity such as to cause a depletion in iron reserves.
To compare outcomes of vaginal and abdominal hysterectomy procedures in women with benign gynaeco... more To compare outcomes of vaginal and abdominal hysterectomy procedures in women with benign gynaecological diseases. This was a prospective study of outcomes of consecutive patients who underwent total vaginal hysterectomy (VH) or abdominal hysterectomy (AH) for benign gynaecological diseases. Patient characteristics before, during, and after the operations were reviewed. Patients were followed up for three months to evaluate postoperative complications. This study included a total of 313 patients. 143 patients underwent AH and 170 patients underwent VH. Baseline characteristics were similar between the two groups. There were no intraoperative complications in either group. Operation time, intraoperative blood loss, first postoperative flatus time, time to out-of-bed activity, mean maximum postoperative body temperature, and duration of fever were all significantly shorter and less severe in the VH group compared with the AH group. In addition, vaginal length in the VH group was signi...
Journal of Ayub Medical College Abbottabad Jamc, 2010
Background: At least 20% of all women and 40% of women over the age of 40 years have uterine leio... more Background: At least 20% of all women and 40% of women over the age of 40 years have uterine leiomyomas. They distort the overlying endometrium and can become extruded or pedunculated (fibroid polyp) in the endometrial canal. The diagnosis of myomas is usually based upon the finding of an enlarged, mobile uterus with an irregular contour on bimanual examination or an incidental finding on transabdominal sonography. The objective of this study was to study the frequency of fibroid uterus in multipara women as observed by physical examination and ultrasonography. Methods: During this descriptive study period all the patients reporting Fauji Foundation Hospital with menstrual irregularity partly and fulfilling the inclusion criteria were included. Results: Out of 140 patients with fibroid uterus presenting to gynaecology department 108 (77.14%) were multiparous while 32 (22.86%) were primiparous. The mean parity was 5. The mean maternal age came to be 46 years. Most common presenting complaint of patients with uterine leiomyoma in this study was menstrual irregularity with menorrhagia in 42 (38.9%), metrorrhagia in 28 (25.9%), polymenorrhagia in 8 (7.4%) patients. The other presenting complaint was abdominal mass which was seen in 25 (23.1%). Conclusion: Multiparous patients were found to have fibroids more frequently than nulliparous in their perimenopausal years, which shows their characteristic slow growth rate. The most common manifestation was menorrhagia.
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