Annals of Punjab Medical College最新文献

{"title":"Antenatal Complications in Grand Multipara Presented at Tertiary Care Hospital","authors":"Sadia Kadir","doi":"10.29054/APMC/2021.862","DOIUrl":"https://doi.org/10.29054/APMC/2021.862","url":null,"abstract":"Background: Grand multiparity considered as a risk factor of obstetrics because of the recorded complications linked to the condition. Grand multiparity typically considered as the distinctive reason for the raised, maternal and fetal morbidity and mortality because of expanded incidence of adverse outcome during pregnancy and birth. Objective: To determine frequency of antenatal complications in grand multipara. Study Design: Cross-sectional study. Settings: Department of Obstetrics and Gynecology, Jinnah Postgraduate Medical Centre, Karachi Pakistan. Duration: Study duration was six months from March 2016 September 2016. Methodology: Total 212 patients were included in this study. Anemia was taken as Hb of 11g/dl, PIH was taken as BP of >140/90mmHg after 20 weeks of gestation with or without proteinuria on two or more occasion 6 hours apart and placenta previa was confirmed via ultrasonography. All the information was collected via study proforma. Results: Patients mean age was 34.90±3.51 years. Most of the patients 96.7% had parity 5-9. Anemia was found 69.8% and pregnancy induced hypertension was 22.2%, while placenta previa was found to be 18.9%. Antenatal complications including anemia, pregnancy induced hypertension and placenta previa were found to be statistically insignificant according to age, parity and BMI, (p->0.05). Conclusion: Most common antenatal complication in this study was anemia followed by hypertension and placenta previa. Grand multiparity is at a greater risk of antenatal complications.","PeriodicalId":319424,"journal":{"name":"Annals of Punjab Medical College","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126542569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Circumcision; A Comparative Study Between ZACH Self-Locking Clamp & Bone Cutter","authors":"Z. Choudhry","doi":"10.29054/APMC/2021.1104","DOIUrl":"https://doi.org/10.29054/APMC/2021.1104","url":null,"abstract":"Background: The circumcision has been performed for religious, ethnic and medical response. In Pakistan 85%-90% of circumcisions are performed by traditional circumcisers. The surgical technique for circumcision involves traditional bone cutter. Objective: To compare the results of one of the most commonly performed surgical procedure, circumcision, by bone cutter and ZACH self-locking circumcision clamp method in terms of complications such as trauma to glans, bleeding and infection along with cosmetic outcome. Study Design: Randomized control trial. Settings: Department of Surgery in Allied Hospital, Faisalabad Pakistan. Duration: September 2018 to November 2019. Methodology: Total 160 patients were selected from OPD on the basis of non-probability consecutive sampling. After careful history taking and physical examination, patients fulfilling the criteria were identified into two equal groups, one underwent circumcision with Bone Cutter and the other with Zach self-locking circumcision clamp. Parents were instructed to follow up in the surgical OPD after seven days for assessment and earlier in case of any complication. Results: There was significant difference in terms of bleeding, superficial infection, cosmetic appearance and trauma to glans (P-value > 0.05). Conclusion: Zach self-locking clamp proved to be safe and effective technique with reproducible results as compared to bone cutter.","PeriodicalId":319424,"journal":{"name":"Annals of Punjab Medical College","volume":"112 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114595217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Νon-Invasive Assessment of Esophageal Varices in Patients with Liver Cirrhosis","authors":"Kiran Namoos, Waqas Shabbir, Imran Ali Zaidi","doi":"10.29054/APMC/2020.973","DOIUrl":"https://doi.org/10.29054/APMC/2020.973","url":null,"abstract":"Background: Esophageal variceal related bleeding is a lethal outcome of portal hypertension in patients with cirrhosis with mortality. Objective: To assess esophageal varices in patients with liver cirrhosis using non-invasive parameters. Study Design: Cross sectional study. Settings: Gastroenterology Department, Lahore General Hospital, Lahore Pakistan. Duration: 6 months from September 2016 to February 2017. Methodology: Data of all cirrhotic patients admitted in medical ward was collected.  Liver cirrhosis was confirmed by abdominal ultrasound. Values of platelet count, serum albumin and serum ALT estimated by automated biochemistry analyzer. Serum ALT / platelet ratio index was measured by formula. Results: It is observed that esophageal varices are most common in middle to old age. 53.9 % of the cirrhosis patients of the age greater than 40 years have esophageal varices.  Mean age of patients with esophageal varices (EV) was 40.94 year. Average duration of cirrhosis was 3.09 years and level of serum alanine aminotransferase (ALT) was raised with thrombocytopenia and low serum albumin. Aspartate aminotransferase / platelet ratio (APRI) index was raised as compared to patients without esophageal varices. Conclusion: Esophageal varices are most common in middle to old age and non-invasive assessment including level of serum alanine aminotransferase, aspartate aminotransferase, serum albumin, platelet count and APRI ratio may help to assess esophageal varices in patients with liver cirrhosis.","PeriodicalId":319424,"journal":{"name":"Annals of Punjab Medical College","volume":"80 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122528105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Various Complications of Chickenpox in Admitted Patients; 2017 Perspective","authors":"Aamir Shaukat, U. Ahmed, Hooria Aamir, Uzma Ismail, Mammona Jahangir, A. Ahmad","doi":"10.29054/APMC/2020.1005","DOIUrl":"https://doi.org/10.29054/APMC/2020.1005","url":null,"abstract":"Background: Chickenpox is a benign disease occurring in both children and adults. Common symptoms of disease include fever, generalized body rash, itching, fatigue, headache and body aches. The complications of the disease include respiratory, gastrointestinal, neurological, hematological and cardiac complications. These complications are more common in adult population. Estimated mortality from chickenpox is 31/100,000 in adults. Chickenpox pneumonia is the most serious complication followed by encephalitis. Objective: To highlight the various complications of chickenpox present in adult population of Faisalabad and its adjoining cities. Study Design: retrospective cross-sectional observational study. Settings: Department of Medicine, Allied Hospital, Faisalabad Pakistan. Duration: One year, January 2017 to December 2017. Methodology: Record of the admitted 350 patients was obtained, and Patients’ charts were reviewed with special emphasis on various complications of chickenpox. The patients included were above the age of 14 years and the diagnosis of chickenpox was made on clinical grounds. The diagnosis of complications was made with the help of laboratory and radiological investigations. Results: In our study 350 patients facing complications from chickenpox, from various regions of Faisalabad. Majority of them suffered from secondary bacterial skin infection i.e. 75 patients. Sepsis and ARDS turned out to be some of the major concerns for patients as well, as 31patients developed Sepsis and 29 patients suffered from ARDS respectively. Hepatitis, Myocarditis and Encephalitis were among the major issues affecting 11, 12 and 9 patients respectively. Conclusion: Chicken Pox can present with life threatening complications in adult population. Awareness of general population about the disease, its prevention, early detection and start of appropriate treatment can prevent development of complications and help reduce mortality and morbidity from the disease.","PeriodicalId":319424,"journal":{"name":"Annals of Punjab Medical College","volume":"88 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131224160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pulmonary Tuberculosis; A Dominant Etiology of Pulmonary Hypertension in Endemic Areas","authors":"A. R. Qureshi, M. Irfan, Z. Ashraf, K. Bhatti","doi":"10.29054/APMC/2020.29","DOIUrl":"https://doi.org/10.29054/APMC/2020.29","url":null,"abstract":"Background: Many patients with chronic lung disorders like infections, COPD, ILD, OSA & Thrombo-embolism, present with dyspnea, not showing adequate improvement by conventional treatment. Most of these were diagnosed as pulmonary hypertension by further multidisciplinary work-up. Such patients show reduced life expectancy due to late diagnosis and insufficient treatment. Many TB patients often remain undiagnosed in this context. The understanding of etiology and risk factors is essential for a high index of suspicion. Objective: To explore the etiology of Pulmonary Hypertension in chronic respiratory patients. Study Design: A Retrospective Observational Study. Settings: Male pulmonology ward, Gulab Devi Chest Hospital, Lahore Pakistan. Duration: 37 months from January 2014 to February 2017. Methodology: 231, consecutive cases, having Age >14 years with clinical and radiological suspicion of pulmonary hypertension were included. Patients having Age >90 years and <14years, not willing for further investigations were excluded. Detailed history, physical examination, radiological, hematological, bacteriological biochemical and immunologic findings were recorded. PH was diagnosed by ECG, Echocardiography, CT-Angiography. HRCT thorax & PFTs, were employed to recognize the underlying lung disorders. Risk factors were identified. Data tabulated, analyzed statistically and conclusions were drawn. Results: 69/231 (29.87%) cases with active and 76/231(32.90%) with old-treated TB, 50(21.64%) COPD, 10(4.32%) pneumonia, 5(2.16%) CLD, six bronchiectasis and three cases of chest deformities were diagnosed PH. Cigarette smoking, DM and obesity were major risk factors. Conclusion: Pulmonary Tuberculosis can be the dominant etiology of PH in high prevalence populations.","PeriodicalId":319424,"journal":{"name":"Annals of Punjab Medical College","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134032423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Intravitreal Bevacizumab in Chronic Central Serous Chorioretinopathy in Terms of Mean Reduction of Central Macular Thickness in Pakistani Patients","authors":"Huzaifa Akhlaq, Minnie Malik, Ejaz Ahmad Javed, I. Ahmad, Shahzad Hassan","doi":"10.29054/APMC/2020.576","DOIUrl":"https://doi.org/10.29054/APMC/2020.576","url":null,"abstract":"Background: Central serous chorioretinopathy (CSCR) is an idiopathic condition described by serous neurosensory retinal detachment at the posterior pole, usually associated with serous retinal pigment epithelial detachment (PED). CSCR patients as a rule have good visual prognosis. In most of the patients, CSCR is self-limiting and patients regain the last visual acuity. However, some patients may have visual disability due to permanent RPE and photoreceptor damage. Objective: The objective of the study is to determine the effect of intravitreal Bevacizumab in cases of chronic central serous chorioretinopathy in terms of mean change in central macular thickness. Study Design: Interventional experimental study. Settings: The study was conducted in Department of Ophthalmology, Allied Hospital, Faisalabad Pakistan. Duration: 2 years from January 2017 to December 2018. Methodology: An aggregate of 95 cases were recruited for the study. Study included both male and female patients with diagnosis of chronic CSCR (at least 6month duration). Best corrected visual acuity, Intra Ocular Pressure on Goldman applanation Tonometer and Optical coherence tomography on Optovue were recorded of both eye of all patients. Before starting the treatment, informed consent was signed by every patient and they were called on the day of injection. Intravitreal off label Bevacizumab (1.25/0.05ml) was given through pars plana in operation theater under aseptic conditions. After injection topical antibiotic drops were given to patients for one week and patients called for follow up after one week, one month, 2 month and 3 months. Same parameters BCVA, IOP, Dilated fundus examine and OCT was recorded on every visit. The final outcome i.e., change in central macular thickness was recorded. Results: In this study, out of 95 cases, 53.68%(n=51) were between 30-45 years of age while 46.32%(n=44) were between 46-60 years of age, mean ± SD was calculated as 46.83+7.82 years, 74.74%(n=71) were male and 25.26%(n=24) were females. Pre-treatment mean central macular thickness was recorded as 344.77+14.61µ which reduced to 154.57+16.57 µ, mean difference was recorded as 190.2+21.46 µ, p value was 0.0001 showing a significant difference. Conclusion: We concluded that intravitreal Bevacizumab significantly reduced central macular thickness in cases of chronic central serous chorioretinopathy.","PeriodicalId":319424,"journal":{"name":"Annals of Punjab Medical College","volume":"253 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116488084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinicopathological Spectrum of Urothelial Carcinoma – A Study from Tertiary Care Set Up","authors":"A. Anwar, Aamir Khan, Farwa Batool Shamsi, Iram Asrar, M. B. Malik","doi":"10.29054/APMC/2020.784","DOIUrl":"https://doi.org/10.29054/APMC/2020.784","url":null,"abstract":"Background: Urothelial carcinoma is the most common malignancy encountered in genitourinary tract. Urinary bladder cancer is the 7th most common malignant tumor worldwide. It is a disease of older age group. Objective: To determine the demographic characteristics of urinary bladder cancer and to analyze the cases of urothelial carcinoma according to gender, age, grade, invasion, histologic subtype, presenting complaints and pathologic stage of specimens. Study Design: Retrospective study. Settings: Pathology Department of Faisalabad Medical University from Department of Urology of Allied Hospital Faisalabad Pakistan. Duration: Three years (January 2015-December 2018). Methodology: Total 305 cases were included in this study. Results: 226 were male patients (74%), and 79 (26%) were females.  Majority of the patients (62%) with urothelial carcinoma in this study were in their 5th and 6th decade of their life. Only 27 patients (8.8%) were below 40 years. Of total cases 149(48%) were of low grade, 150(49%) were of high grade and only 6 cases (2%) fell under the category of lesion named PUNLMP. 151(49%) cases were detrusor muscle invasive and 151(49%) were non-invasive and only 3 (1%) cases were found in which no muscle biopsy was identified. 99% of patients were diagnosed with commonest type of tumor that is transitional cell carcinoma, while only 3 (1%) cases were of transitional cell carcinoma with squamous differentiation. Painless visible hematuria was the most common presenting complaint (96%) followed by dysuria (3%) and storage symptoms (1%). Majority patients lie under the pathologic stage pT1(50%) then in pT2(48%). A significant co-relation was found between gender and a grade of tumor. Female patients (60%) presented with higher grade and aggressive disease. Patients of younger age group (below 40) were diagnosed with low grade carcinoma. Conclusion: Urothelial carcinoma is a disease of elderly people with a significant predominance of male patients. Painless hematuria is the most common presenting symptom.","PeriodicalId":319424,"journal":{"name":"Annals of Punjab Medical College","volume":"90 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134068923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of the Intracorporeal Ultrasonic Lithotripsy and Intracorporeal Pneumatic Lithotripsy in Terms of Stone Removal and Postoperative Complications","authors":"M. Ayub, S. Jahan, Fiaz Ahmad Tauqeer, Faisal Masoud, Ijaz Siddiqui, M. Nazir","doi":"10.29054/APMC/2020.1029","DOIUrl":"https://doi.org/10.29054/APMC/2020.1029","url":null,"abstract":"Background: Urolithiasis is the most common and painful urological disease. Intracorporeal lithotripsy has high success rate in management of ureteric stone. Objective: To do comparison of the intracorporeal ultrasonic lithotripsy and intracorporeal pneumatic lithotripsy in terms of rate of stone removal and post-operative complications. Study Design: Randomized Control Trial. Settings: Department of Urology, Lahore General Hospital, Lahore Pakistan. Duration: Six months from September 01, 2015 to February 29, 2016. Methodology: Total sixty patients were selected fulfilling the inclusion criteria into 2 groups. In group A, 30 patients were selected for intracorporeal ultrasonic lithotripsy and in group B, 30 patients were selected for intracorporeal pneumatic lithotripsy. In both groups all patients were compared in terms of rate of stone removal and postoperative complications then results were analyzed by SPSS 21. Results: Mean stone size in group A (Ultrasonic lithotripsy) was 1.13 ± 0.17 cm and in group B (Pneumatic lithotripsy) was 1.14 ± 0.18 cm. At first week after procedure, in group A 25(83.33%) and in group B 21(70%) of the cases had stone clearance, at 2nd week after procedure a total of 26(86.66%) in group A and 24(80%) cases in group B had stone clearance. At 3rd week after procedure there were 28(93.33%) cases in group A and 27(90%) cases in group B had stone clearance. The stone clearance in both groups at each follow up was statistically insignificant, p-value > 0.05. At 1st week, in group A 3(10%) cases and in group B 6(20%) cases had pain, at 2nd week after procedure there were 1(3.33%) cases in group A and 3(10%) in group B who reported pain and at 3rd week after procedure there were 1(3.3%) case in each group had pain. The pain at each follow up was statistically same in both groups, p-value > 0.05. According to complications, in group A and group B, 2(6.66%) and 3(10%) cases had fever, 3(10%) and 4(13.33%) had infection respectively. Only one case (3.3%) had retention of urine. All complications were statistically same in both groups, p-value > 0.05. Conclusion: Through the findings of this study we conclude that both intracorporeal pneumatic lithotripsy and intracorporeal ultrasonic lithotripsy are equally effective and had fewer complications. However, the ultrasonic procedure had higher rate of stone removal at each follow up (but difference was insignificant with similar morbidity compared to pneumatic devices.","PeriodicalId":319424,"journal":{"name":"Annals of Punjab Medical College","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131525856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does Written Informed Consent Comprehensively Inform Surgical Patients and is This Effective in Patient’s Decision-Making?","authors":"M. Ahsan, Abeer Irshad, Isbah Rashid, S. Waqar, Jawaria Faisal, Abdul Qadir Khuram","doi":"10.29054/APMC/2020.730","DOIUrl":"https://doi.org/10.29054/APMC/2020.730","url":null,"abstract":"Background: Informed consent (IC) is first fundamental principal step in health care helps patients to be conscious of consequences of their treatment decisions. The importance of obtaining a valid inform consent before any procedure well established with surgery and it is an important aspect of doctor patient relationship. Objective: To assess outcome of different management strategies in women presenting with primary postpartum hemorrhage (PPH). Study Design: Observational, prospective. Settings: General surgery department of Pakistan Institute of medical Sciences Hospital Islamabad Pakistan. Duration: Five months from March 2019 to July 2019. Methodology: All the patients were asked a set of standard questions, which related to the information they had provided before the operation as a part of standard informed consent practice. The surgeons had taken all the interviews with privacy and confidentiality after postoperatively at the earliest time the patient is comfortable to do so. The questions were asked in the simple languages, which were understandable to patients, so that patients could easily understand and respond to the same. The questionnaire sought information risks/benefits associated with a surgical procedure, alternate treatment options, whether providing additional detailed verbal and/or written information improved their understanding. All the information was recorded via study proforma. Results: Total 183 patients were interviewed post-operatively regarding inform consent and most of them 42.1% were between age 18-40 years. Males were 58.5% and females were 41.5%. Almost all cases had received informed consent, while some said they received just before the surgeries. There were some controversial answers regarding question of oral information influence the decision to proceed to the surgical procedure. Almost all patient had answered that they were informed regarding their conditions, surgical and anesthetic complications prior the surgery. Only 7.7% patient said that the time was not given for the questions and 10.4% patient were unsatisfied regarding informed consent, while the most of the cases were satisfied. Conclusion: In the study observation mostly, patients were satisfied and because mostly surgical consent element is generally understood, but some remained controversial and should consider its importance, beyond risks of the procedures, as well as acceptability and feasibility of intervention to surgical team and patients. Written information has not provided patients with adequate decision-making tools for imminent health matters, so pre-operative oral information also needed to adequate decision-making.","PeriodicalId":319424,"journal":{"name":"Annals of Punjab Medical College","volume":"104 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114313978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary Postpartum Hemorrhage and Maternal Health-Effects and Outcome","authors":"A. Sadaf, Zahida Parveen Brohi, U. Parveen","doi":"10.29054/APMC/2020.989","DOIUrl":"https://doi.org/10.29054/APMC/2020.989","url":null,"abstract":"Objective: To assess outcome of different management strategies in women presenting with primary postpartum hemorrhage (PPH). Study Design: Observational, prospective. Settings: Department of Obstetrics & Gynecology Unit-III, Liaquat University of Medical and Health Sciences, Jamshoro Pakistan. Duration: From May 2016 to November 2017. Methodology: Total 50 delivered women fulfilling the inclusion criteria were included in study. All relevant variable like a detailed demographic characteristics, details about labour, symptomatology, general conditions of patient, amount of blood loss, clinical examination, finding such as condition of the uterus, genital tract trauma, retained placenta, uterine inversion. Investigation like complete blood picture blood group, blood sugar, coagulation profile, serum electrolytes, virology status, liver function test, renal function test, ultrasound examination, maternal effects and outcome were recorded on proforma and analyzed by using SPSS. Results: Among 50 women (with primary PPH) included in this study, all were managed medically, in 24 patients medical treatment was unsuccessful so surgical treatment offered. Most common cause identified was uterine atony, however anemia 50(100%).  Hypovolemic shock 5(10%), puerperal sepsis 8(16%), complication of anesthesia 4(8%), blood reactions 6 (12%) were the morbidities observed in present study, 2 patients (4%) died inspite of all measures. Conclusion: It was concluded that best results were obtained with use of AMTSL, combination of more than on medical option and surgical management were equally effective in treating the PPH.","PeriodicalId":319424,"journal":{"name":"Annals of Punjab Medical College","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129610193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}