Background: Over diagnosis of isolated oligohydramnios is associated with increased obstetrical intervention without improving maternal and perinatal outcome. Objective of this study is to evaluate two methods of amniotic fluid volume assessment regarding obstetrical intervention frequency and its effect on maternal and perinatal outcome. Materials and Methods: This prospective study was conducted at a Private Hospital of Dera Ismail Khan and Khyber Teaching Hospital, Peshawar from 1st January 2017 till 31st December 2019. All pregnant patients with singleton, un-complicated pregnancy with period of gestation from 41 weeks to 41 weeks 6 days, live fetus were included in the study. Women who met the eligibility criteria were assigned to two different techniques of amniotic fluid assessment, first amniotic fluid index( AFI) method and second single deepest vertical pocket(SDVP) method. Data was recorded on a specially designed proforma. The socio-demographic variables were age in years, parity. Continuous variable was measured on numerical scale and expressed as mean and SD. Research variables were maternal outcome and perinatal outcome in terms of oligohydramnios frequency, induction of labour, caeserean section, fetal distress, NICU admission, A/S < than 7 at 5 minutes. Chi-sq test of significance was applied. Results: A total of 160 patients met the inclusion criteria. In first group 30 (37.5%) and in second group18 (22.5%) had oligohydramnios. In AFI group 10 (33.3%) and in SDVP group 3(16.66%) had caesereans section. Induction of labour was 30(37.5%) in AFI group and 18(22.5%) in SDVP group. These results were statistically significant with a p value less than .05 at 5% significance level. Fetal distress, A/S < than 7 at 5 minutes, NICU admission results were not statistically significant for two groups. Conclusion: SDVP technique gave less abnormal results, less intervention with no significant difference in maternal and perinatal outcome. Keywords: Amniotic fluid, Oligohydramnios, Caesarean section.

Background: Bleeding is common during pregnancy and it is quite normal during first trimester. As the first bleed indicates, implantation of fertilized egg in the lining of uterus. It is common complication of almost 16-25% of pregnancies. 20% of the women experience light or spotted bleeding. Half of these pregnancies survive while the rest lead towards miscarriage. The first trimester bleed can be because of different pathological conditions mainly: miscarriage, cervical bleeding, infection and ectopic pregnancy. Methodology: Women with bleeding or pain or both in pregnancy, without any conclusive analysis from December 2020 to December 2021 were presented to Gynecology ward, of DHQ Hospital, Timergara and Khyber Teaching Hospital, Peshawar. Evaluation was done with history and physical examination counting ultrasonography, pelvic examination, an HCG level and cervical cultures. 60 gravid females with less than 20 weeks of gestational age that presented with substantial per vaginal bleeding were recruited into the study population. Patients were properly counseled and each patient was given informed oral consent before being recruited for the research. Information about these prenatal, obstetric, and puerperal patients was recorded in an organized obstetric data sheet. SPSS version 16.0 was used for analysis of data. The chi-square test was used to evaluate relationships among groups. Results: The mothers mean age in the study and group of control was 24.7 ± 3.2 years and 23.93 ± 3.3 years, correspondingly (P> 0.05). The study group has mean parity of 1.9 ± 1.3 and in the control group 2.1 ± 1.4 (P> 0.05). At the time of presentation; mean gestational age for bleeding in the study group was 12.3 ± 1.68 weeks and for control group, it was 12.4 ± 1.39 weeks (P> 0.05). The comparison in both groups was accomplished but no significant differences in relations of birth history, gestational age and age was noted. Conclusion: The study found that recurrent episodes of bleeding per vaginal in late gestation and bleeding per vaginal in early gestation were related with premature delivery, low birth weight and miscarriage. Keywords: Apgar scores, Abruptio placentae, placenta praevia, low birth weight.

Background: Prostatic cancer is the 2nd most common malignancy in men. The understanding of incidence of malignancy along with Gleason grading of tumor is significant that led the development of investigations for early detection and prompt treatment of patients Aims: The aim of this study is to determine the incidence of malignancies with Gleason grade in patients with clinically enlarge prostate glands. Materials and Methods: This is a descriptive cross sectional study conducted in Rahbar medical and dental college from 100 patients with clinically enlarge prostate glands from January 2018 to December 2020. Results: A total 100 prostatic biopsies were examined histologically from January 2018 to December 2020. Out of 100 biopsies 12(12%) cases were diagnosed as adenocarcinoma and 88 (88%) were benign lesions. The age of patients ranges from 52 to 95 years with mean age of patients was 73.5 years. Majority (41.66 %) of adenocarcinomas reported as Gleason grade group 5. In 16.66 % cases the malignancy was incidental as clinically there was no any suspicion of carcinoma. Perineural invasion was noted in 66.66% of adenocarcinomas, and in 16.66% of cases lymphovascular invasion was reported, that correlates with higher grade of tumor. Conclusion: Majority of the tumor diagnosed were in grade group 4 that shows increased death rate. Prostate cancer is continue to rise and screening of every patient with enlarge prostate should be done for early detection of malignancy. Keywords: prostate gland, adenocarcinoma, Gleason grade

Background: Typhoid fever is endemic in South Asia and is the most common bacteremic illness in children in Pakistan, with rates as high as 1000 cases per 100000 child-years having been reported from Karachi. The occurrence of multidrug-resistant (MDR) Salmonella enterica strains has been highly reported from developing countries. Fluoroquinolone resistance has also been highly reported. Clinical cases of cephalosporin-resistant Salmonella enteric isolates have also been reported recently leading to spread of XDR strains. Methodology; Between 1st January-31st December 2021, a total of 1385 blood sample were processed for identification of enteric fever isolates. The blood samples were inoculated in the tryptic soy broth bottles. The strain identification was initially performed by Gram staining, and by using API 20E. For serovar confirmation, agglutination assays were performed using antisera. The antimicrobial susceptibility testing for the Salmonella enterica isolates was performed using the disc diffusion method according to the (CLSI) standards for the following antibiotics; ampicillin, amoxicillin, piperacillin-tazobactam, ceftriaxone, cefotaxime, cefepime, imipenem, meropenem, ciprofloxacin, chloramphenicol and trimethoprim-sulfamethoxazole Results: A total of 425(30.68%) samples gave positive growth. Sixty-two (14.58%) isolates were identified as Salmonella enterica species. Eight isolates (12.90%) were from < 5 years of age group, 35(56.45%) from 5 to 15 years age group. Species differentiation revealed, 52(83.87%) were Salmonella typhi and 10(16.12%) were Salmonella paratyphi A. Sensitivity pattern of the isolates (n=62), indicated 29(46.77%) were multi-drug resistant (MDR), while 32(51.61%) were extensively-drug resistant (XDR). Conclusions: Both governmental and nongovernmental organizations in Pakistan need to actively promote vaccination campaigns and healthy hygiene habits and discourage irrational use of antibiotics to prevent the mortality and morbidity associated with increasing antibiotic resistance in pathogens. Safe water supply, personal hygiene and effective antibiotic policies can help us to control the disease therefore reducing antimicrobial resistance. Keywords: Antimicrobial resistance, salmonella enteric, bacteremic illness