Informatics Publishing Limited

Abstract

Background: Breech is the most common malpresentation.There is hardly any Obstetrician who have not missed breech presentation occasionally during his/her professional carrier. Objective: An assessment of factors affecting the mode of delivery in breech presentation. Materials and Method: An analysis of one hundred cases of single tone pregnancies with breech presentation was done at a tertiary care hospital. Statistical analysis; findings were expressed in terms of simple proportion. Findings: Of the total one hundred breech delivery conducted, 46 percent were assisted breech deliveries, 5 percent were spontaneous breech deliveries, breech extraction was done in only 2 percent cases and 47 percent were Caesarean section. The fate of primae was, 61.70 % undergone C-section in comparison to their counterparts 34.01 % delivered vaginally. This points to the trend of primae with breech towards C-section. Similarily 66 percent multigravidae delivered vaginally showed that the maternal pelvis has stood the taste of a previous delivery. Conclusion: The authors reached to the conclusion that a shift towards modernization resulted in increase in C-section birth. This is not necessarily good thing. The woom in unnecessary surgeries is jeopardizing women health. Unwanted C-section is costlier than the natural birth and raises the risk of complications for the mother. Hence efforts must be made to bring awareness in the community because natural birth is the ideal one. Any C-section is to be performed in the interest of the mother and child-and that too after a careful evaluation. A regular antenatal check up ,close clinical monitoring during labour and timely intervention is always helpful.

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Methods: This post operative randomized double masked clinical trial comprised patients with age related cataract having undergone extracellular cataract extraction (ECCE) with or without posterior chamber Intra ocular lense implementation (PC-IOL). They were randomly assigned to use topical timoilol or betaxolol or levobunalol or acetazolamide or intracameral pilocarpine (Group 1a/1b/1c/1d/.1e) respectively at the completion of the surgery. Two controls were taken- a. Intra-ocular pressure in the follow eye (Control-I) b. Intraocular pressure in the operated eye ,in which no Introcular pressure reducing drugs had been instilled (Control-II ) (Group-II). Intraocular pressure (IOP) was measured 6 hours, 24hours, 3^rd day, 7^th day and 2^nd month postoperatively. The anterior chamber was examined for the levels of cells and flare using slit lamp examination.

Results: Levobunalol was more effective in reducing post operative IOP rise at 6 hours of surgery, 3^rd day, 7^th day 1^st month, and 2^nd month where as Timolol was more effective at 24 hours. There were significant difference in IOP between Group-I (those patients who received topical iop reducing drugs) and group-II (operated patients without any IOP reducing drugs) post operatively (p<0.05). No excessive postoperative inflammation was observed in any group. In the control group-I (fellow eye), IOP remained constant throughout the period. This indicated that the drugs were not playing any major role in altering IOP of the fellow eye. In the control II (group-II), maximum mean pressure rise was 18 mm Hg at six hours. This indicated that it was the operative procedure that was causing the rise in IOP. Diurnal variation in IOP was playing no significant role.

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