Objectives: The study aimed to determine dietary Intake patterns in women with GDM and Non-GDM, a comparative study in a tertiary care hospital, Pakistan. Methods: This comparative cross sectional study was conducted through questionnaire spread over a period of six months of pregnant women visiting to Abbasi Shaheed Hospital for ante-natal visit having 24 to 28 weeks of gestation. With the written consent of the participants dietary intake patterns were assessed in GDM & Non-GDM subjects by a three day 24 hours’ recalls and food frequency questionnaire. A 24-hour dietary recall chart is a dietary assessment tool in which participants were asked to recall all food and drink they have consumed in the last 24 hours. The FFQ (food frequency questionnaire) provide a list of foods and participants were asked how often they eat each item on the list. This FFQ has 70 food items. The food frequency was reported as never, per year, per month, once a week, once and a day. The reported intake of food was converted into nutrients intake (carbohydrate, protein, fat) which was calculated by reported intake frequency of each food multiplied by reported portion size and its respective nutrient composition, summing over all foods by a trained Nutritionist. Results: A total of 75 participants with GDM, and 75 with Non-GDM were enrolled in this study over a period of six months. It was observed that dietary intake patterns have a significant association with GDM. Those who consume carbohydrate mainly containing diet have likely to have GDM. It has been seen that those who have family history of diabetes are more likely to have GDM. Family dietary patterns can affect risk of GDM. Our study has shown that timings of meals did not find have any significant association with GDM. Conclusion: Dietary patterns strongly influence the risk of GDM. The most contributing factors to risk of GDM are higher intake of carbohydrate rich diet and lesser consumption of fruits and vegetables. doi: https://doi.org/10.12669/pjms.38.7.5889 How to cite this:Nadeem S, Khatoon A, Rashid S, Ali F. Dietary Intake patterns in women with GDM and Non-GDM: A comparative study. Pak J Med Sci. 2022;38(7):---------. doi: https://doi.org/10.12669/pjms.38.7.5889 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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.

Objective: To compare cervical ripening in women having evening primrose oil with those not taking it. Study Design: Retrospective Cohort study. Setting: Department of Obs & Gynae, Abbasi Shaheed Hospital, Karachi. Period: July 2018 to April 2021. Material & Method: Patients were divided into 2 groups, one having evening primrose oil (EPO) 1gm twice daily from 37 weeks till labor, given by her previous birth attendant. Another group was without using evening primrose oil. Both were examined for cervical ripening by bishop score, length of labour and then for need for cesarean section. Statistical plan: SPSS 20. Results:  BISHOP score for EPO group (6.1) vs non-EPO group (4.3) was statistically significant (p-value < 0.001). EPO have soft cervical consistency (73.5%), followed by medium (10.2%) and firm (16.3%) while non EPO have firm consistency (41.2%) followed by soft (37.3%) and medium (21.6%). The differences was statistically significant (p-value=0.001). The average length of labor for EPO group was 7.7 hours (±2.5 SD) and Non-EPO was 8.4 hours (±2.4 SD), statistically insignificant. The mode of delivery wasn’t statistically significantly different between two groups. Conclusion: EPO tend to have soft cervical consistency. However mode of delivery between EPO group and Non-EPO group did not have any significant difference.

Objective: To assess diagnostic accuracy of visual inspection of cervix with 3-5% acetic acid(VIA) as a screening method for early detection of cervical intraepithelial neoplasia and early cervical cancer.Method: This cross-sectional study was conducted at Gynecology & Obstetrics Department Unit-1, Abbasi Shaheed Hospital, Karachi, from April 2017 to September 2018. Participants were included in the study through non-probability convenience sampling technique. Married, non-pregnant and sexuallyactive women aged between 21-50 years were included in the study. Demographic information and relevant history was taken followed by the procedure for VIA. Acetowhite changes were noted after application of 5% acetic acid on the cervix. The result of the test was documented as positive or negative. Colposcopy was done in all VIA positive cases and suspicious cases with abnormal looking cervix. Biopsy of the cervix was taken for histopathology to assess the results of VIA. SPSS version-20 was used for statistical analysis.Results: There were 323 subjects with a mean age of 35.5 ± 7.6.Out of 323 participants only 6 were found VIA positive (1.86). On histopathology, only two cases were found positive (0.62%), one early invasive cervical cancer and one CIN1. Sensitivity, specificity, positive predictive value and negative predictive value of visual inspection of cervix after acetic acid application was 100%, 57%, 40%, 100%respectively and the diagnostic accuracy was 66.7%. Conclusion: Visual inspection of cervix with 3-5% acetic acid is highly sensitive, screening method for cervical cancer. It is quite simple, affordable and better screening modality for detecting cervical cancer at an early stage.