Frequency and risk factors of cognizable physical violence by intimate partner against women seeking medical care at a tertiary care centre, Karachi

Objective: To determine the cognizable frequency of physical violence by intimate partners against women seeking medical care at a tertiary care center, Karachi

Methods: A hospital based cross sectional survey was conducted at a medical care emergency of a tertiary care center, Karachi. The sample size was 345. A non-probability purposive sampling technique was used for selecting the study subject. A Performa was used to collect the information directly through recorded data and interviews. Written informed consent was obtained from each participant. Data was entered and analyzed by using SPSS software version 15. Means with standard deviation for numerical variables and proportions for categorical variables are presented. Chi square test was performed for association of education level and occupation with frequency of physical violence by intimate partners

Results: There were 345 cases reported during August 2014 to February 2015. Mean age +/- SD was 33.50 +/- 8.41 years and family income 1,855 +/- 962 rupees per month. Cognizable physical violence was observed in 286 [77.7%] by intimate partners against women seeking medical care at a tertiary care center Karachi. Housewives were 271 [78.6%] seeking care for physical violence injury. Fractures were found in 226 [65.5%] women. There was no education in 46 [13.3%] and 5 year education was 191 [55.4%]. The percentage of cognizable physical violence was 77.7%. Non-cognizable physical violence found higher among younger age group 24-36 years as compare to older women

Conclusion: The frequency of cognizable physical violence was two third by intimate partners against women seeking medical care in metropolis megacity, Karachi. Major risk factors found were age more than 36 years, housewives, low family income and only five years education

Domestic violence causing abruptio placenta and feto-maternal death: case report on autopsy

A 22 year old primigravida with 28 weeks/7 months pregnancy was brought in police custody 10 hours after her death reported at a Tertiary Care Center, Karachi. There was a history of soft tissues direct abdominal trauma 10 hours back. On complete physical examination there were no external marks of violence except a contusion on her back of 5 cm diameter. The internal examination after opening the uterus, placenta was separated and baby was delivered after opening the amniotic sac. A fresh still birth of male baby with 1.5 kg was delivered. The chemical and histopathology report evidenced that uterus, fallopian tubes and ovaries had decidua with necrotic tissues, edema and congestion. The final opinion after receiving the chemical/histopathology reports on this post mortem was that the death occurred due to fetal hypoxemia developing secondary to maternal shock as a result of direct uterine trauma and disseminated intravascular coagulation [DIC]. DIC develops due to circulating placental products responsible for fetal losses. This case reports fetal hypoxemia developing secondary to maternal shock, maternal hypotension, abruptio placentae, direct uterine trauma and disseminated intravascular coagulation [DIC]

Serum cholesterol levels and incidence of ovarian tumors in Pakistani women

This study was aimed to observe the relationship of serum cholesterol with incidence of ovarian tumors [benign and malignant] in pre and postmenopausal Pakistani women. Effect of type [benign and malignant] and state of disease [FIGO stages of malignant tumors] on serum was also the objective of the study. Thirty-five clinically and histopathologically confirmed patients with benign and malignant tumors [mean age 47.05 with rang of 16-70 years] selected. Nineteen age and weight matched healthy control subjects were selected among the female staff members and students of JPMC. Serum cholesterol was estimated by kit method. In case of benign tumor patients lowest level of serum cholesterol was observed in serous cyst adenoma [p<0.0005] and ovarian cyst of undetermined origin [p<0.001]. The lower cholesterol levels were also observed in other groups when compared with controls [p<0.0005]. Statistically significant differences were noted when serum cholesterol levels compared between stage 1 and III [p<0.05] between 1 and IV [p<0.001] II and IV [p<0.05] and between III and IV [p<0.01]. Findings of this study suggests that lowest levels of total cholesterol [TC] has been observed in various is benign and malignant tumors and the inverse correlation between low total cholesterol levels to incidence and mortality of tumors is more markedly associated with the advance disease status. This finding of inverse relation of TC with increase incidence of cancer is in agreement with the several prospective epidemiological studies carried out by various researchers