Background: Subclinical maternal thyroid dysfunction adversely affects the obstetrical outcome. Treatment of subclinical hyper or hypothyroidism clearly improves the pregnancy outcome. Therefore screening of thyroid function in pregnancy is the need of time.Objective: To determine the frequency of subclinical thyroid dysfunction among pregnant women with bad obstetrical history Design: Cross sectional studySampling technique: Non-probability convenient sampling Materials and methods:This study was done at Chohan Reproduction and Assisted Fertility Treatment Center (CRAFT-IVF) in duration of 2 year. 260 pregnant women of age 18-40 years with bad obstetrical history were enrolled. Informed consent was obtained and demographic history like, age, gestational age, obstetrical details were taken. Blood samples were taken for thyroid hormones i.e. fT3, fT4, and TSH levels in first antenatal visit in outpatient department. Interpretation of thyroid dysfunction was done. Data analysis was done on SPSS version 16.0.Mean and standard deviation calculated for fT4, fT3 and TSH. Frequency and percentages were calculated for subclinical thyroid dysfunction.Results: 260 pregnant females were enrolled in study to evaluate subclinical thyroid dysfunction. Mean age of the patients was 30.31 + 3.11. Mean fT4 level was 1.84 ±1.12ng/dl, fT3 2.62 + 1.14ng/dl and TSH level was 4.32 ± 0.91mIU/l. Thyroid dysfunction was observed in 118 (45.4%). Out of which subclinical hypothyroidism was noted in 77 (65.2%) pregnant whereas subclinical hyperthyroidism in 41 (34.7%) of patients with bad obstetrical history. Conclusion:Frequency of subclinical thyroid dysfunction is high in our population so it should be considered and managed in pregnant women especially with bad obstetrical history.

Study Design: An analysis of 14 cases of ruptured uterus was done during January 2003 to December 2003 in Obstetrics & Gynae Department of Lahore General Hospital, Lahore. Objective: The purpose of this Audit was to analyse the different management options, maternal and fetal outcome in uterine rupture. Material and Methods: Total no of births in 2003 was 4840. Total number of ruptured uterus found to be 14 (2.9%/1000) deliveries. Among these incomplete rupture were 3 (21.4%) and complete rupture were 11 (78.4%). Regarding the common sites of uterine rupture lower uterine segment interior surface = 11 (78.4%). Lower uterine segment posterior surface = 2 (14.2%) and upper uterine segment rupture was = 1 (7.14%). The most common cause of uterine rupture was found to be multiparity and injudicious use of oxytocin by TBA in 5 cases. (35.7%) and previous uterine surgery in 5 cases (35.7%). 2 cases (14.21) were due to cephalopelvic disproportion due to hydrocephalus and 2 (14.2%) cases were of malpresentation (transverse lie) mostly handled at home by TBAs. Hysterectomy, total or sub total was done in 7 cases (50%). Repair of uterus was done in 5 cases (35.7%), in 2-cases (14.2%). Bladder repair alongwith uterine repair was done. In two cases (14.2%) of scar dehiscence, repeat cesarean section was done. The maternal mortality was found to be zero, while intrauterine death were 10(71.4%) and alive babies were 4 (28.5%) high perinatal mortality of 71% were found. Conclusion: Ruptured uterus is avoidable catastrophe by proper education, training of patients and TBA`s and by providing effective family planning services, transportation, diagnostic facilities and by reducing the unnecessary caesarean section.

Introduction: Various studies have widely documented how weight (being overweight, underweight or obese) plays a significant role in increasing health problems and adversely affects the quality of life. Out of all the weight-related issues, obesity is the number one contributing factor for causing health problems. To overcome this factor, a trial was conducted where a drug 'Lite plus’ (Garcinia Cambogia and Green Coffee bean) was given to a select number of people for a period of three months. Materials and Methods: 'Lite Plus' is a drug which contains Garcinia cambogia 500 mg + Green Coffee Bean Extract 400 mg, with a recommended dosage of 2 tablets/day with or before meals for 3 months. Most of the patients included in our study were females suffering from obesity-related problems such as PCOs and Infertility. During the trial, all patients were given the recommended dosage of 'Lite plus', while those with diabetes had the dose amended accordingly. Results: As a result of this trial, it was found that the use of 'Lite Plus' was very effective in decreasing weight/BMI with continuous use. After 6 weeks, out of the 250 respondents participating in the trial, 232 got a reduction in their BMI, and after 12 weeks (end of the trial), 29 respondents (11.6%) reached the desired level of BMI. Conclusion: Garcinia cambogia and Green Coffee bean are effective and safe in weight reduction.

The leading cause of maternal death from eclampsia is cerebral hemorrhage, which is presumably the consequence of severe hypertension, so the acute elevations in blood pressure above 160/100 mm Hg should be brought under control. A study of forty diagnosed cases of eclampsia was carried out in Lady Willingdon Hospital, Lahore to determine the time and quantity of drug required to control high blood pressure levels by intravenous hydralazine bolus dose versus continuous infusion drip. Patients were divided into control and case group. In control group continuous infusion was given and in cases bolus dose was given. Mean time taken to control blood pressure by continuous infusion was 124.75 minutes and drug quantity was 23.50 mg while it was 52 minutes and 12.25 mg in case of bolus method. The study showed that 60-70% less time was required and 37.5-50% less drug quantity was used in bolus method versus continuous infusion of intravenous hydralazine. Regarding efficacy of intravenous hydralazine, it was fou nd to be statistically superior in this study (P<0.05) so that management strategy should be changed in favour of bolus dose as compared to continuous infusion of intravenous hydralazine.