Background: Letrozole, an aromatase inhibitor that inhibits the final step of the estrogen biosynthesis pathway to prevent estrogen synthesis, has been utilized in a variety of infertile scenarios. A common gynecological pain problem called endometriosis involves tissue that resembles the tissue that typically lines the inner layer of the uterus. It frequently results in fertility issues. According to the trials, the Letrozole medication continues to reduce the severity of persistent pelvic pain. According to reports, Letrozole therapy relieves pelvic pain brought on by endometriosis. Objective: In this study, we evaluated Letroszole's effectiveness in treating chronic pelvic discomfort associated with endometriosis. Study Design: A cross-sectional study Place and Duration: This study was conducted at Sandeman Provincial Hospital (SPH) / BMCH, Quetta Pakistan from December 2021 to December 2022. Methodology: A total of 60 patients with endometriosis were taken in this study. Patients with a past history of treatment for endometriosis with varying degrees of improvement were also included. Data was analyzed on SPSS version 24.0. Before starting the treatment, an initial diagnostic laparoscopy was used to diagnose and score endometriosis. Oral administration of Letrozole 2.5mg, celbex 200mg three times a day, calcium citrate 1000 mg, progestin norethisterone acetate 5 mg, and vitamin D (1000 IU) was given for 6 months Results: The mean age of the participants was30.9years. A total of 26 (43.3%) patients presented with dysmenorrhea. Out of 60 patients, 43 (71.6%) were nulliparous. The mean visual analogue scale which was 7.12 at the start of the therapy, dropped to 6.8 (p-value 0.02) in one month and dropped to 3.3 in six months of the therapy. Conclusion: Letrozole has been shown to be effective in treating pelvic pain related to endometriosis, with notable pain reduction and no recurrence of symptoms. Keywords: Letrozole, Endometriosis, pain score

Objectives: To determine the frequency of asymptomatic bacteriuria in pregnantwomen. Study design: Descriptive, Cross sectional study Place and Duration: Department of Obstetrics & Gynaecology, Benazir Bhutto Hospital, Rawalpindi. 26th December 2017 to 25th June 2018 Materials & Methods: A total of 151 pregnant women of gestational age ≥28 weeks, 18 to 40 years of age were included. Patients with genital tract trauma, history of UTI in the past one year and urinary tract stones were excluded. Then clean-catch midstream urine was collected from each woman into a sterile universal container and sample was sent to the institutional laboratory for presenceor absence of asymptomatic bacteriuria. Results: Age range in this study was from 18 to 40 years with mean age of 28.78 ± 3.90 years. Majority of the patients 84 (55.63%) were between 18 to 30 years of age. Mean gestational age was 31.06 ± 1.67 weeks. Mean parity was 3.17 ± 0.99. Mean BMI was 27.44 ± 3.02 kg/m2. In our study, frequency of asymptomatic bacteriuria in pregnant women was found in 25 (16.56%) patients. Conclusion: This study concluded that frequency of asymptomatic bacteriuria in pregnant women is quite high. Keywords: Asymptomatic Bacteriuria, Pregnancy, Urinary Tract Infection.

Background: Premenstrual syndrome is a cyclic disorder with symptoms that are severe enough to interfere with some aspect of living. The debilitating symptoms reappear with each cycle, the most common being generalized headache, breast swelling and tenderness, bloating, fatigue, depression and irritability. Aim: To determine the efficacy of mefenamic acid in treatment of premenstrual syndrome women in reproductive age groups. Methods: A quasi experimental study was donein the Department of Obstetrics and Gynecology, Federal Government Services Hospital, Islamabad between November 2020 and April2021. The study was carried out over 75 patients. Mefenamic acid for at least 3 months and followed up for a minimum of 3 months were advised. After follow up the sequel of symptoms and efficacy was noted. Results: Average age of the patients was 26.03±6.27 years. The symptoms of premenstrual syndrome nausea 84%, gastrointestinal tract disturbance 85.3% and headache 80% noted to be the leading symptoms followed by breast tenderness 77.3% and vomiting 74.7%.The efficacy of mefenamic acid in term of relieving of symptoms was observed 70.7%.Statistically significant improvement in symptoms of headache, dysmenorrhea, breast tenderness and mood irritability were noted (p ≤ 0.05). While no clinically significant distinction found among marital status, occupation, education and duration of symptoms improvement (p ≥ 0.05). Practical implication of the study is that the effect of mefenamic acid relieving the symptoms of PMS. Conclusion: The study concluded that mefenamic acid is effective in term of relieving symptoms in patients with premenstrual syndrome. Keywords: Mefenamic acid; Efficacy; Premenstrual syndrome; vomiting.