We report the case of a 52-year-old gentleman, admitted to the medical intensive care unit with multiple organ system dysfunction due to acute severe pancreatitis. He was found to have severe hypocalcemia, bradycardia and an electrocardiogram (EKG) showing ST-segment elevation in infero-lateral leads. The patient was treated with intravenous calcium gluconate with prompt improvement of heart rate and reversal of EKG changes. Subsequent evaluation for myocardial ischemia was negative. We believe the EKG changes mimicking acute ST-segment elevation myocardial infarction were due to severe hypocalcemia. To our knowledge this is very rare occurrence.
Structural and physical changes take place in pregnancy such as altered function of urinary tract. The mechanism lying behind low urinary tract function can be described in terms of effects of hormones, compressive dysfunction of uterus and structural changes in pelvic support function. The prevalence of urinary incontinence in developed countries is 27.6% and in developing countries 28.7%. Urinary incontinence is a functional pelvic floor disorder which affects the wellbeing of all age's women. Urinary incontinence frequency is increased by pregnancy but the cause of this incontinence is still unknown. The prevalence of incontinence differs greatly.
Objective:To know the frequency of urinary in- continence among pregnant multigravida from second trimester up to delivery. Methods: The study design used was a cross-sectional survey. The place of study was Lady Aitchson Hospital Lahore Pakistan and Lady Willington Hospital Lahore Pakistan. It was completed within six months after the approval of synopsis from September 2015 to February 2016. The sample of this study was 706. Mean age of the multigravida belonging to the lower socioeconomic status was 25-28 years of age. Women's continence and pelvic health center urinary incontinence questionnaire was used in this study. Results: Multigravida included in this study showed 51.1% of urinary incontinence and 48.8% with no urinary incontinence. The level of the beginning of urinary incontinence was more in second trimester. Conclusion: Urinary incontinence is more prevalent in multiparous especially in second trimester of pregnancy.
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