Background Pakistan and other developing countries need to address disparities in maternal health care and factors associated with it. This justifies tracking the progress on two important indicators 'spousal violence' and 'maternal health care utilization' to improve maternal health and achieve Sustainable Development Goals (SDGs) for these nations. Objective The objective of this study is to compare the data from the latest two Demographic Health Surveys of Pakistan to identify trends in prevalence of various forms of spousal violence and maternal healthcare utilization and to determine the predictive role of spousal violence in poor maternal health. Methods We conducted a retrospective analysis of nationally representative data from the 2012-13 and 2017-18 PDHS. The data used in this analysis is from the domestic violence module and core women's questionnaire. Spousal violence and sociodemographic background were predictor variables. Terminated pregnancy, number of pregnancy losses, number of antenatal visits for last birth and institutional delivery for last birth were taken as indicators of maternal health. Logistic regression analysis was conducted to test for association between maternal health indicators and various forms of spousal violence after controlling for sociodemographic variables.

Introduction: Many women of reproductive age experience polycystic ovary syndrome (PCOS), characterized by growth of cysts on the ovaries that range in size from 2 to 10mm in antral measurement, oligomenorrhea, menorrhagia, acne and hyperandrogenism. Objective: The study aimed to correlate the rational of PCOS with infertility in women. Place and Duration: The study was conducted in different districts of Sindh in Pakistan during the period 2020-22. Methods: This cross-sectional study aimed to determine how common infertility was among women with PCOS who sought care at different gynecological clinics. Pathological investigation of the patient's hormonal profile, including serum insulin, serum prolactin, LH, FSH, and serum testosterone levels were also investigated. Results: 316 of infertile women (63.20%) were diagnosed with PCOS. Females had oligomenorrhea as the predominant (p<0.05) pattern of the PCOS-affected females. Acne, hirsutism, and hyperandrogenism were significantly (P<0.05) more common among these women. In women with PCOS, the level of testosterone was significantly elevated (132+2.39 ng/dl; P<0.05). Conclusion: PCOS is the leading cause of infertility owing to anovulation, as affected women displayed severe clinical manifestations of oligomenorrhea, hirsutism, acne, hyperandrogenism, and elevated testosterone levels and thus can easily be diagnosed and treated accordingly.

Background: Menopause is a natural process, occurring in women that marks the end of fertility among women. It is characterized by a cessation of menstruation, decline in ovarian activity and disturbances in periods along with vaginal dryness, mood swings and hot flashes. The age of menopause ranges in between 40 to 55 years. Although there are many factors affecting the age of menopause onset like metabolic syndrome, cytotoxic drugs, but there is no general agreement on them. Objectives: To explore the factors affecting age of onset of menopause among Pakistani women. Methodology: This cross-sectional-observation study was conducted on 139 women (aged at or above 40 years) presenting to the Outpatient Department of Obstetrics – Gynecology at Jinnah Medical College Hospital, Karachi – Pakistan from Nov 2020 to May 2021. Data was collected using a structured interview-based questionnaire containing inquiries pertaining to basic biodata, sociodemographic details, menstrual history, and probable factors affecting age of onset of menopause. Chi-square test was applied to check the association between the different factors and age of menopause. Results: The mean age of the participants was found to be 43.23 ± 4.11 SD years, while the mean age of onset of menopause was recorded to be 49.21 ± 3.83 SD years. The associations between the marital status, body mass index, use of OCP and socio-economic factors with age of onset of menopause, were found to be statistically significant. Conclusion: Menopausal age not only reflects the end of fertility era but also of aging as well. Age of menopause significantly effects physical and psychological health of women and is considered as a very important event in women’s lives. Controllable factors like obesity, tobacco use, use of OCP plays a significant role in age of onset of natural menopause.

Objective: To evaluate the postoperative abdominal wound problem after hysterectomy with scalpel versus electrocautery for skin and subcutaneous dissection. Material and Methods: A total of 516 post-menopausal women having age 40 to 65 years who were planned for elective hysterectomy were included in this study. Patients having only benign disorders were included. In group E (N=258); Skin incision and tissue dissection was done using electrocautery by setting the electrocautery machine at cutting mode at 30 to 50 watts’ power. In group S (N=258); conventional scalpel was used for skin incision. Scalpel number 23 was used for skin and subcutaneous tissue dissection. Post-operative wound complications such as seroma, hematoma, wound dehiscence and wound infections were primary study endpoints. Results: Mean age was 48.6±6.9 years in electrocautery and 49.2±6.3 years in scalpel group (p-value 0.30). Seroma formation was diagnosed in 98 (37.98%) patients in electrocautery group and in 52 (20.1%) patients in scalpel group (p-value <0.0001). Wound infections were diagnosed in 50 (19.3%) patients in electrocautery group versus in 87 (33.7%) patients in scalpel group (p-value 0.0002). Hematoma was diagnosed in 10 (3.87%) patients in electrocautery group and in 19 (7.4%) in scalpel group (p-value 0.08). Conclusion: The use of electrocautery is associated with lower rate of post-operative wound infections and hematoma formation. The present study advocates the use of electrocautery for skin and subcutaneous tissue dissection in patients undergoing abdominal hysterectomy. Keywords: Abdominal hysterectomy, electrocautery, scalpel, wound complications.

The most popular form of family planning is tubal ligation. Decades-long debates have surrounded the possibility of the post-tubal ligation syndrome of menstrual irregularities. Objective: To study the frequency of menstrual irregularities after tubal ligation in women attending gynecological outpatient department of a tertiary care hospital setting. Methods: A cross sectional study was conducted on 126 females who had history of post tubal ligation syndrome. Cases were verified and data were collected. Duration and length of menstrual cycle was noted. Laboratory examination was done. Duration of tubal ligation was also noted. Their age, name and hospital registration number were also noted down. A control group of 50 healthy females was made for the comparison of menstrual disturbance. Result: The patients mean age was 39.5±3.4 years. Maximum of the patients 71(56.3%) of the patients had age between 37 to 42 years. The duration of tubal ligation observed in 118 (93.7%) of the patients more than or equal to 1 year. Type of menstrual disturbance such as polymennorrhea in 76(60.3%), menorrhagia in 51(40.5%) and intermenstrual bleeding in 9(7.1%) of the patients respectively. Final outcome menstrual irregularity was presented in 74 (58.7%) of the patients. Age group with menstrual irregularity was presented in 40(53.5%) patients versus 31 (43.7%) patients who had absent menstrual irregularity. Similarly, duration of tubal ligation was compared with menstrual irregularity and presented in 69(58.5%) of the patient compared with 49(41.5%) patients who had absent menstrual irregularity. Conclusion: The older group of patients has high prevalence of menstrual irregularities.