Background: Caesarean section (CS) is one of the most common obstetric procedures worldwide and an increased rate of caesarean section has been observed in recent studies. Maternal morbidities and mortality associated with repeat caesarean section is an important health problem. The present study aims at knowing the various intraoperative complications encountered during repeat caesarean sections. Objective was to study the incidence and type of surgical difficulties encountered in repeat cesarean sectionsMethods: It was a prospective observational study of 118 cases of repeat cesarean sections. Intra-operative findings of all cases were analyzed to know the difficulties encountered because of previous cesarean section.Results: In present study, out of total 118 cases of previous cesarean sections, 71 (60.17%) cases were of previous one caesarean section and 47(39.83%) were of previous two cesarean sections. Following intraoperative morbidities were encountered – adhesions (1 caesarean section vs 2 caesarean section – 40.85 vs 65.96% respectively) , thin lower uterine segment (1 caesarean section vs 2 caesarean section – 21.13 vs 36.17% respectively), advanced bladder(1 caesarean section vs 2 caesarean section – 15.49 vs 36.17 % respectively) , extension of uterine incision(1 caesarean section vs 2 caesarean section – 9.86 vs 19.15% respectively) , scar dehiscence(1 caesarean section vs 2 caesarean section –7.04 vs 31.91% respectively), excess blood loss (1 caesarean section vs 2 caesarean section –7.04 vs 19.15% respectively), 1 case of placenta accrete was found in previous 2 caesarean section 2.13%) which needed caesarean hysterectomy. uterine rupture and bladder injury seen in one patients of previous 2caesarean section. Time taken for surgery was more in repeat CS group Delivery.Conclusions: An increasing number of CS is accompanied by increased maternal morbidity. Intraoperative complication which increase the risk of morbidity are adhesion, placenta accreta. It is prudent to involve a senior experienced obstetrician in repeat cesarean section. The best way to reduce this is by reducing primary caesarean section rates. Patients with previous caesarean section should be considered as high risk and should be counseled for regular antenatal check-up and they should be given option of vaginal birth after CS whenever possible.

Objective: Frequency of Glucose – 6- Phosphate Dehydrogenase deficiency in neonates presenting with jaundice Study design: A cross-sectional study Place and Duration: Pediatric department, civil hospital Karachi from January to June 2019 Methodology: The study included all infants who were hospitalized in the neonatology unit with jaundice. At the beginning of the trial, the parents of each neonate gave their assent after being assured that there would be no monitoring burden placed on the parents for the examinations. When entering the hospital, the researcher himself completed a predesigned proforma that asked for specific details about the patient's age, sex, ethnicity, jaundice onset age, consanguinity, and family history of G6PD deficiency. Investigations on newborns included measuring serum bilirubin and looking for signs of G6PD deficiency. (Estimation of G6PD enzymes). Sigma Diagnostic G6PD Reagent was used to estimate the G6PD enzymes for the qualitative, visual, and calorimetric assessment of G6PD deficit in red blood cells. When the sample's deep blue colour changes Results: 174 infants with jaundice in total were included during the study period. Participants in the study had an average age of 16.12 +/- 7.2 days. 95 (54.6%) of the 174 study participants were men, and the male-to-female ratio was 1.2:1. It started at an average age of 8.83.8 days. 79 (45.5%) out of a total of 117 (67.2%) participants are Pathans by consanguineous marriage. 23 (13.2%) of the 174 subjects were G6PD deficient. According to a stratified analysis, out of 23 G6PD-deficient newborns, 11 (47.8%) were between 1 and 11 days old, 19 (82.6%) were between 0 and 6 days old, and 14 (60.8%) had blood bilirubin levels below 15 mg/dl. Conclusion: It was concluded that G6PD is a common cause of neonatal jaundice in our setup. Keywords: Neonates, Jaundice, G6PD deficiency

Background: Pregnancy is a very crucial time in a woman’s life. In this period of time, not only multiple physiological alterations effect the usual health status but also makes women more vulnerable to contract infection and face negative sequalae. Hepatitis C, a blood borne viral infection serve the similar fate when encountered by pregnant ladies. This study is based on exploring the prevalence of the Hepatitis C virus seropositivity among pregnant population. Moreover, we also evaluated the major risk factors leading to the infection in these mothers. Besides this, infected mothers were studied for their pregnancy outcomes.Methods: In this study 114 pregnant females were observed for this cross-sectional study. It was conducted in Gynecology Unit- 1, Liaquat University Hospital Hyderabad, for the period of January 2017 to July 2017. Chi square test was applied for statistical analysis on SPSS version 16. The criteria for enrollment in the study was set to be a pregnant lady belonging to age group 20-35 years; having singleton pregnancy; was a booked case at the hospital with compliant to antenatal follow ups; admitted to the labor room for delivery. All the non-pregnant ladies, whom had co morbid conditions such as hypertension or diabetes or had infected with hepatitis B or D were excluded from the study. Furthermore, pregnant ladies with multiple gestion or those who were either diagnosed of hepatitis C prior to conceive or had a previous history of hepatitis C were also excluded.Results: Present study revealed that out of 114, 10(8.8%) pregnant ladies were found seropositive for Hepatitis C virus. Prior history for transfusion of blood was the Foremost risk factor discovered, with 60.5% women reported this. History of surgery was the 2nd commonest factor and 43.9% had this in their medical records. On the other hand, only 8.8% women gave the history for previous evacuation. While observing pregnancy outcomes, we found 48.2% neonates had low birth weight, 41.2% were born preterm and 21.1% had low APGAR score.Conclusions: In a nutshell hepatitis c is prevalent in the pregnant population of this region and showing its effects in the form of compromised pregnancies. History of blood transfusion and previous surgery were found to be chief risk factors in the study.