Aim: To determine the maternal outcomes in women presented with severe pre-eclampsia. Study Design: Prospective/Observational Place and Duration: Obs & Gynae department of Akhtar Saeed Medical and Dental College and Hospital, Lahore and Kausar hospital/Khairpur Medical College, Khairpur Mir’s Methods: Total 100 patients with ages 18 to 45 years presented with pre-eclampsia were included in this study. Patients detailed demographic including age, parity, gestational age, and body mass index were recorded after taking written consent. Patients complete blood picture was examined. Complications associated with preeclampsia were examined. Data was analyzed by SPSS 23.0. Results: Out of 100 patients 23 (23%) were ages <20 years, 42 (42%) were ages 20 to 30 years, 30 (30%) were ages 31 to 40 years and 5 (5%) were ages above 40 years. 41 (41%) were primigravida while 59 (59%) were multigravida. Mean gestational age was 34.11±3.88 weeks. HELLP syndrome found in 21 (21%) patients, 11 (11%) patients had eclampsia, and 16 (16%) patients had placental abruption, coagulopathy found in 4 (4%) patients, 3 (3%) patients developed acute renal failure and 2 (2%) patients were died. Conclusion: It is concluded that pre-eclampsia is highly associated with major maternal complications such as HELLP syndrome, eclampsia, placental abruption and maternal mortality. Keywords: Pre-eclampsia, HELLP Syndrome, Placental Abruption, Eclampsia, Mortality

Background and aim: Postpartum hemorrhage (PPH) is still a leading cause of maternal morbidity and mortality globally. Postpartum hemorrhage is characterized as excessive bleeding (> 500 ml) from the vaginal tract following childbirth. The present study aimed to determine the frequency and clinical outcomes of women with postpartum hemorrhage. Materials and Methods: This cross-sectional study was conducted on 1346 patients who underwent vaginal delivery in the department of obstetrics and gynecology, Kausar Hospital, Khairpur Mirs from March 2021 to March 2022. The study included all the women who had postpartum hemorrhage following vaginal birth in the labor room or who were referred with primary postpartum hemorrhage. Patients with prior history of bleeding disorders and on warfarin were excluded from the study. SPSS version 26 was used for data analysis. Results: Of the total 1346 patients, the prevalence of postpartum hemorrhage was 12.6% (n=170). Out of 170 PPH cases, the incidence of primary and secondary PPH was 138 (81.2%) and 32 (18.8%) respectively. The age-wise distribution of patients were as follows: 26 (15.3%) had <20 years, 62 (36.4%) in 21-30 years, 68 (40.1%) in 31-40 years, and 14 (8.2%) in >40 years. The incidence of primiparas, multipara, and grand multipara were 34 (20%), 58 (34.1%), and 78 (45.9%) respectively. The booked and unbooked patients were 56 (32.9%) and 114 (67.1%) respectively. Among 170 PPH patients, the incidence of spontaneous vaginal delivery, instrumental delivery, and cesarean section were 52 (30.6%), 56 (32.9%), and 62 (36.5%) respectively. The major causes of PPH was uterine atony, perineal and vaginal tears, and prolong labor found in 112 (65.9%), 56 (32.9%), and 38 (22.4%) respectively. Conclusion: The present study concluded that the prevalence of PPH was 12.6% among total cases. Primary PPH was more prevalent than secondary PPH and uterine atony was the most common cause followed by perineal and vaginal tears and prolong labor. Additionally, unbooked patients were more susceptible to PPH. Risk factors assessment, unnecessary induction, and third stage labor active management can prevent the PPH. Keywords: Postpartum hemorrhage, Clinical outcomes, Uterine atony

Objective: To determine the frequency of organisms causing vaginal discharge. Study Design: Descriptive study. Setting: Department of Gynecology and Obstetrics Unit-II of Kausar Hospital Khairpur Mirs, Sindh. Period: 23rd, October 2019 to 22nd January 2020. Material & Methods: Study population include sexually active females aged 18-45 visiting to the OPD for complain of vaginal discharge. A complete history and examination was done for assessment of the patient for reproductive tract infections. Results: In one year time period 420 females reported to the OPD of the hospital. Out of total 1783 patients, 23.5% patients (n=420) had complaint of vaginal discharge. Out of 420 patients enrolled in the study, 43.8% (n=184) patients were diagnosed having non-infective vaginal discharge. Bacterial vaginosis had the highest prevalence among common reproductive tract infection estimating about 46.1% (n=109) cases. Conclusion: Multiple researches must be conducted on large scale to determine the actual ratio of reproductive tract infections in sexually active females. Furthermore awareness session should be delivered to the rural and urban population. Awareness to women regarding their sexual health and their positive influence on society should be given.

Background: Lamotrigine is a member of antiepileptic drugs, it belongs to the sodium channel blocking agent’s class and it is pregnancy category C drug. While its teratogenic effects are not hidden by the doctors but it is the preferred drug being prescribed in pregnancy. The current study aims to investigate the effects of fetus resorption and histologic changes in cranium of fetus of albino mice and to compare their weight changes due to lamotrigine therapy. Methodology: It was an experimental animal study conducted in collaboration of anatomy and surgery department at animal house of University of Lahore in 2019. The duration of study was 25 days, twenty-four albino mice (12 males and 12 females) were placed in conventional cages in pairs for mating purpose. Female mice Group A, controls in which normal saline was administered intraperitoneally on 10th day of gestation and Group B, in which lamotrigine was given intraperitoneally on the 10th day at the dose of 10 mg/kg. Maternal health was monitored daily during the intervention. Body weight, food and water consumption, and changes in general health, behavior, activity and any sign of toxicity were checked daily. After 18th day the pregnant mice were sacrificed under euthanasia and fetuses were removed and histologic assessment was carried out. Results: Weight of mice treated with lamotrigine decreased significantly (p-value=0.03) and fetus resorptions were also more (p-value=0.013) in Group B. Histologic assessment reveled that there were cleft of lip and palate in group B. Conclusion: Lamotrigine increased the fetal resorption and decrease the weight and seemed to be responsible for inducing cleft of lip and palate at 10mg/kg dose in albino mice.

Background: The carbonated drink manufacturing companies has set young school/college going children as their primary target customers who are consuming it on daily basis and frequency of drinking vary depending on affordability and need. The consumption of carbonated drink has been increased recently that has led us to think about its unwanted effects on health. It has been identified that consuming more carbonated drinks may cause low bone mineral density. Objectives: To identify the frequency of consumption of carbonated drinks in medical students and to assess the knowledge regarding adverse effects of theses drinks and association of BMD. Methodology: It was a cross sectional study conducted at Baqai Medical University Karachi from May to August 2020. Students of MBBS 4th year and BDS final year were approached, sample size was calculated at 50% precision of total population i.e 100 participants were recruited by convenient sampling from the mentioned classes. Preformed questionnaire was administered to identify the frequency and knowledge regarding the subject and bone mineral density through Single x-ray absorptiometry (SXA). Results: The study participants almost (90%) were aware of the name carbonated drink of, 85.5% were aware regarding the harmful effects, and 75.5% were having knowledge about the ingredients. Majority were aware regarding health related effects but they were not having knowledge about names of the specific diseases. There was no significant (0.079) association between carbonated drink consumption and BMD. Conclusion: Students were aware of health related hazards caused by carbonated drinks there was no association of carbonated drink consumption and BMD.