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Background Caesarean section rate is increasing throughout the world, which increases the risk of complications in subsequent pregnancy with increased maternal and foetal morbidity and mortality. There is risk of uterine rupture in subsequent pregnancy with trial of labour after caesarean section (TOLAC). Therefore, accurate prediction of uterine rupture can be of significant value during the management of subsequent pregnancies after previous caesarean delivery. The aim of this study was to evaluate the accuracy of prenatal transabdominal sonography in determining the lower uterine segment thickness in women with previous caesarean section, to document relevant risk factors in the obstetric history of subjects predisposing to uterine scar rupture and to define a cut-off value of uterine thickness for prediction of uterine rupture. Methods This cross-sectional validation study was conducted in the Department of Obstetrics and Gynaecology, Ayub Teaching Hospital, Abbottabad from May to October 2017.Transabdominal ultrasound was carried out in all patients before labour for the measurement of uterine scar thickness. Patients were followed till caesarean section and intraoperative findings were recorded. Results A total of 117 patients were enrolled. Out of these 33% had thin or dehiscence/rupture scar. At the cut-off value of ≤5 mm the sensitivity was 76.9%, specificity 48.7% and accuracy was 58.12%. No significant association was found between clinical features and scar dehiscence/rupture. Conclusions No definite USG cut-off limit could be established to provide guidance regarding the clinical decision of opting for VBAC or repeat caesarean/section; scar thicknesses ≤5.0 mm should be judged cautiously.Background Patient suffering from psoriasis can be severely affected in their day to day activities and it may also result in reduced work efficiency and absenteeism from work leading to financial burden on the patient's family. This study was conducted using Dermatology Life Quality Index to assess the quality of life of a patient suffering from psoriasis being treated at a military hospital. Methods This cross-sectional study was conducted in the outpatient unit of Department of Dermatology, Combined Military Hospital Abbottabad from 1st October 2013 to 31stJune 2014. The demographic data and Dermatology Life Quality Index of patients of psoriasis were recorded using a standard questionnaire and their final score was calculated to assess the effect of disease on patient's life. Extent/ severity of disease were assessed according to the body surface area involved. The data was analysed using SPSS- 18. Mean and SD for numerical variables and frequencies and percentages for categorical were calculated. Results A total of 160 patients fulfilling the inclusion criteria were included in the study. Mean age of the patients was 40.48 years (±12.58 years) with minimum age of 18 years and maximum of 74 years. 118 patients were males were (73.8%) and 42 were females (26.2%). selleck products Twenty (12.5%) patients had no effect on their life by the disease while 5 (3.1%) had extremely large effect. Most patients, i.e., 68 (42.5%) had moderate effect on their lives. 69 patients had mild psoriasis as per body surface area involved, 70 had moderate disease and 21 had severe disease. Conclusions Psoriasis affects quality of life of patients not only physically but also psychologically and financially even when patients are under treatment. Psychological aspects also need to be addressed while treating the physical morbidity.Background Increasing rate of caesarean section is becoming an epidemic worldwide. This study was conducted to compare rate of caesarean section between women presenting in labor with cervical dilatation less than 4 cm to those with cervical dilatation 4 cm or more. Methods This study was conducted at Aga Khan Hospital for Women, Karimabad. Women with singleton pregnancy and cephalic presentation at term in spontaneous labour were included. Patients were divided in two groups early presenters with cervical dilatation less than 4 cm and late presenters with cervical dilatation of 4 cm or more. Primary outcome measured was rate of caesarean section, while secondary outcomes were duration of labour, APGAR score and any neonatal complication. Results Medical records of 442 women were reviewed. Difference in mean age of women presenting early in labour was of 2 years (26.8±4.7 vs 28.4±4.5) which was significant (p-value 0.01). More than two thirds of primiparas presented early (69.0% vs 31%) in labour and early presenters had longer labour (p-value less then 0.001). 62% of early presenters had artificial rupture of membrane compared to 41% of late presenters and nearly 73% required analgesia (p-value less then 0.001). Caesarean section rate was 10.5% in early and 1.8% in late presenters that was significant (p-value less then 0.001). APGAR score of both groups was comparable. Conclusions Integrated midwifery services and antenatal classes may help in education of labouring women and their understanding of labour process and so that low risk women can be monitored at home and come to hospital in active labour.Background Preclinical determination of occlusal plane is an important clinical step in construction of complete denture. Objective of present study was to find out the parallelism of occlusal plane to ala-tragus line in dentate subjects to provide a guideline for establishment of occlusal plane for edentulous patients. Methods In local dental College from April to October 2017 using purposive sampling technique this comparative study was conducted. After preliminarily examination, desired photographs of 120 subjects using fulfilling the inclusion criteria were taken biting on proper positioned Fox's Plan. Photographs were analysed through the computer software named Digimizer Image Analysis (Version 4.2.5.0) for three posterior reference points on the tragus of the ear at its superior (ATs), middle (ATm) and inferior (ATi) margin and one anterior reference point, i.e., Inferior margin of the Ala of the nose. Three lines were drawn with the help of the software that were extending from the posterior reference points to anterior reference point and fourth line Parallel to the upper level of the fox plane (FxP).
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