Aim: To evaluate the factors behind primary and secondary infertility in females through diagnostic laparoscopy. Study design: Cross sectional study Place and duration: This study was conducted at Bilawal Medical College Kotri Hospital/Liaquat University of Medical and Health Sciences Jamshoro, Pakistan from June 2019 to July 2020 Methodology: The present study is a cross sectional study conducted at at Bilawal Medical College Kotri Hospital/Liaquat University of Medical and Health Sciences Jamshoro, Pakistan from June 2019 to July 2020. A total of 115 females were included in the study and they all underwent diagnostic laparoscopy after setting strict inclusion criteria. Data was recorded on proforma and analyzed on IBM SPSS version 22. Primary and secondary infertility frequency was calculated and analyzed. Result: A total of 115 infertile women were considered in the study and results were recorded after performing diagnostic laparoscopy on all of the participants. Total 74 (64.35%) had primary infertility and 41 (35.65%) reported secondary infertility. Total 19 (25.67%) participants of primary infertility and 5 (12.19%) participants with secondary infertility showed no abnormality. The most common abnormality found was tubal blockage in 17 (22.97%) women of primary infertility and 13 (31.70%) women of secondary infertility. Total 11 (14.86%) patients of primary infertility were diagnosed with polycystic ovaries (PCO). PCO was absent in patients with secondary infertility. Total 9 (12.16%) cases of primary infertility and 5 (12.19%) cases of secondary infertility were diagnosed with Endometriosis. Total 2 (2.7%) cases of primary infertility and 7 (17.07%) participants with secondary infertility presented with Pelvic Inflammatory disease (PID). A total of 6 (8.10%) cases having primary infertility were observed with periovarian adhesions and Peritubal adhesions, whereas, 9 (21.95%) cases of secondary infertility were seen with these issues. Conclusion: Tubal occlusion, periovarian adhesions, peritubular adhesions, and endometriosis were the most common factors behind infertility in both primary and secondary infertility. Ovarian cyst and polycystic ovarian disease were only present in patients with primary infertility. Keywords: Diagnostic Laparoscopy, Primary infertility tubal occlusion, Secondary infertility

Aim: To determine the prevalence of anemia in rural pregnant patients and its relationship with education and birth spacing. Study Design: Cross sectional study Place and duration: This study was conducted at Abbasi Shaheed Hospital Karachi, Pakistan from August 2019 to August 2020 Methodology: Total 450 pregnant ladies visited the OBS/Gyne department at Abbasi Shaheed Hospital Karachi, Pakistan for a check-up, treatment, and follow-u were included. The percentage of hemoglobin was used to determine the diagnosis of anemia. The SPSS program version 21.0 was used to analyze the data. The Chi-Square test was used to look into the association between the variables. Result: Out of 450 subjects, we found that 291 pregnant ladies were anemic. We found that 64.66 % of the population suffers from anemia. 43.98 % (n=128) of the cases had mild, 30.92 % (n=90) had moderate, and 25.08 % (n=73) had severe anemia. Total 13.74% (n=40) females were under 20 years of age. Women aged 20 to 25 years old made up 52.92 % (n=154). It has been discovered that there is a link between age and the severity of anemia. (P0.001) (X2=25.68). The degree of anemia in pregnant women is linked to their educational level and the spacing of their births. (P<0.001) Conclusion: Anemia is common among pregnant women visiting Abbasi Shaheed Hospital Karachi, Pakistan. Low birth spacing and a lack of education are also linked to severity of anemia. Keywords: Anemia, Pregnancy, Birth Spacing, Pakistan

Aim: To determine the prevalence of trichomonas vaginalis infection in sexually active women Study design: Cross sectional study Place and duration: This study was conducted at Muhammad Medical Collage Mirpurkhas, Pakistan. From Jan 2020 to Jan 2021. Methodology: The present study was conducted on 120 sexually active women. Factors that can influence its infestation such as age, occupation, number of sexual partners, and education of the participant were also studied. A detailed history and symptoms were recorded on the proforma. Clinical examination of the participants was done to assess the signs in the genital tract. Following the standard protocol, two swabs from the posterior fornix of each patient were collected. The wet mount technique and culture of the swabs were carried out in the laboratory. The IBM SPSS version 26 was used to analyze the data. Result: A total of 120 participants were chosen after evaluating them on the basis of inclusion criteria and only 9 (7.5%) participants were detected with Trichomonas infestation. The mean age of the patients were 31±10.5 years ranging from 18 to 60 years. All of the infected participants were married and had one sexual partner. All of them had clinical symptoms. There was a positive association of Trichomonas Vaginalis infection and education, occupation, clinical symptoms, and marriage. Conclusion: In our study the prevalence of Trichomonas Vaginalis infection was low. However, there were certain factors that were influential on the infection promotion. Keywords: Trichomonas Vaginalis, infection, prevalence, Trichomoniasis, women

Aim: To assess the association between premature rupture of membrane and maternal blood vitamin D levels. Study Design: A cross-sectional study. Place and Duration: Abbasi Shaheed Hospital, Karachi Medical and Dental College from April 2020 to April 2021. Methodology: Over the duration of one year, a total of 100 patients with vitamin D levels, as well as obstetrical abnormalities and risk factors, were monitored. In 88 pregnant women, vitamin D deficiency was observed. Pregnant women who have a thyroid disorder, such as thyroiditis or Grave's disease, or who had calcium or parathyroid disease in the past, or who need cardiac medication therapy,& diuretic particularly calcium channel blockers were excluded from the study. Results: Vitamin D deficiency was found in 88 pregnant women out of 100. It was more prevalent among housewives (86.36 percent) and multiparous women (68.0 percent). Pregnancy complications were present in 33.0 percent of cases such as preeclampsia, gestational hypertension, and diabetes, and PROM was less prevalent in the deficient group. Conclusion: Our data indicate that pregnant females are at a greater risk of Vitamin D deficiency, and associated pregnancy complications. The correlation between maternal vitamin D levels & preterm rupture of the membrane was not statistically significant.

Objective: Coronavirus disease 19 (COVID-19) Vaccination is critical approach in restricting the COVID-19 epidemic in order to curb infections and diminishseverity of illnessparticularly among most vulnerable group such as pregnant women. Therefore, this study was intended to assess the attitude of women in pregnancy toward COVID-19 vaccination. Methodology: This was a cross-sectional observational study conducted in the outpatient Department of Gynecology and Obstetrics of Abbasi Shaheed Hospital, Karachi by using non-probability convenient sampling technique. The duration of the study was about 6 months from October 2021 to March 2022. A total of 325 pregnant women having pregnancy of after 14 weeks and before 34 weeks, who were physically and mentally fit with no past history of acute or chronic systemic disorder were included in the study. For quantitative variables mean and standard deviation was recorded and for qualitative variables frequency and percentages were reported. Results: The study results showed thatthe mean age of the participants was 28.92 ± 5.18 years, mean parity was 2.61±1.80, and mean gravidity was 3.66±1.86. When asked about their intention to receive the COVID-19 vaccine, 167(51.4%) participants indicated fear of pregnancy complication while 158(48.6%) had no fear. 170(52.3%) participants showed fear of complication related to baby. About 65(20.0%) were concerned about safety of vaccine. Most of the participants 290(89.2%) agreed that isolation methods and social distancing are not enough. 235(72.3%) believed that COVID-19 vaccine can protect from the infection only 90(27.7%) participants did not believe on effectiveness of vaccine. Conclusion: This study concluded that despite the low educational level of pregnant women, most of the participants showed positive attitude and willing to be vaccinated. However, majority pregnant women had fear of detrimental effects for the fetus and mother that were two major concerns among pregnant women when considering COVID-19 vaccination