Objective: This study was conducted with the aim to approach the diagnostic accuracy of fine needle aspiration cytology in supraclavicular lymph node swelling at outpatient department. Methods: The study is cross-sectional, descriptive conducted at General Surgery department Unit-III, of PUMHSW, Nawabshah, Sind, from 1st January 2019 to 31st December 2020. After the written permission from ethical Review Committee of PUMHS-W, all the patients attending Surgical/Medical outpatient department with supraclavicular lymph node swelling and sent for cytological examination from 1st January 2019-31st December 2020 were entered in SPSS-20, after filling of specially designed proforma. All the variables/demographic details were entered and analyzed by SPSS version 20. Results: Total of 153 cases diagnosed at the Department of Pathology, PUMHS-W, and Nawabshah during the two-year period. The most commonly lesion was TB Lymphadenitis 58(38%),and 43(28%) were cases of Reactive Hyperplasia, while the malignant metastatic lesions were 38(25%) and Lymphoma and NHL were positive in 5(3%) cases. The metastatic lesion were most commonly involve the left side 23(60.5%) and less commonly the bilateral 3(8%) involvement. The common metastatic malignancy found was squamous cell carcinoma 14(37%) followed by adenocarcinoma, undifferentiated carcinoma, small cell carcinoma, papillary thyroid carcinoma, ductal carcinoma breast, hepatocellular carcinoma and seminoma, 10(%), 5(% ),2(%), 2(%), 1(%), 1(%), 1(%) respectively. The most commonly involved age group by mixed lesions were 41-50 years of age, and less common group involved was above 70 years of age. The metastatic malignant lesion were commonly found in 61-70 years of age group and lymphoma and Non Hodgkin Lymphoma were seen up to 60 years of all age groups. Conclusion: Fine Needle Aspiration Cytology is a reliable diagnostic tool as it is cheap, less invasive, and timed modality for diagnosing the supraclavicular lymph node inflammation/metastatic and nodular malignancies.

Objective: To determine the frequency of Advance maternal age pregnancy, its associated risk factors and complications, and to evaluate the obstetric and fetal outcome. Methods: Cross-sectional study, carried out at a Tertiary Care Hospital of Nawabshah, with a total of 125 Advance age (> 35 years) mothers who gave birth during the study period. Questionnaire based data was collected, statistically analyzed and results were tabulated. Results: A total of 125 (17.85%) Advance age mothers (>35 years) were recruited for the study. Among this study group Cesarean Section (52%) remained the most observed mode of         delivery. Pregnancy related complications included Postpartum hemorrhage (44%), Gestational diabetes (22.4%), and Pregnancy induced hypertension (16%). The neonatal complications mostly observed were, still birth (35%), Low birth weight (17.5%), Preterm birth (26.3%), and Neonatal death (14%). Conclusion: Advancing age exposes mother to have pregnancy related complications and adverse neonatal outcomes.

Aim: To determine the frequency of teenage pregnancy with associated risk factors and various complications, and to evaluate the obstetric and fetal outcome. Methods: This cross-sectional study was conducted at the departments of Community Medicine, Pathology and Gynecology & Obstetrics, Peoples University of Medical and Health Sciences, Nawabshah, and Suleman Roshan Medical College Tando Adam, from January 2019- June 2020, consisting of 108 teenage mother group (13-18 years) and 108 adult primigravid reference mother group (19-22 years) that gave birth during the study period. Results: The teenage group had mostly Spontaneous vaginal delivery 61.11% (n=66). Majority of the teenage mothers suffered from pregnancy complication of anemia 72. 2% (n=78) compared with the reference group 22.2% (n=24). 46.29% neonates of the teenaged group mothers developed complications including Low birth weight 52% (n=26), Preterm Birth 10% (n=5) and most serious complication Perinatal death 4% (n=2) compared to the reference group. Conclusion: The teenage pregnancies are high risk pregnancies with potential maternal and fetal complications.

Aim: To assess the frequency and association of obstetric complications in extreme of maternal ages. Methods: A cross-sectional comparative study was conducted at a tertiary care hospital of district Nawabshah, Sindh and Suleman Roshan Medical College during the period April 2019- May 2020. The data regarding adverse obstetric outcomes of all teenage (<18 years) compared with the reference group of (19-22 years) and women of (>35 years) were compared with reference (31-34 years of age) delivering at the facility. The frequencies, percentages were derived as part of descriptive statistics, chi-square was used for parametric testing with 0.05 level of significance and odds ratio were applied to compare the risk of extreme age groups with their respective reference groups. Results: A total of 104 participants were recruited in this study among 16.3% accounted for teenage (<18 years) and 34.6% accounted for advanced maternal age (> 35 years). Multivariate association between maternal age groups and the adverse obstetric variables were taken into account. Elevated rates for all adverse obstetric outcomes were observed between the variables among extreme-age mothers compared to reference group. The differences were statistically significant with p-value of 0.001 respectively. The chi-square test was found to be insignificant for other factors such as socio demographics, obstetric history and mode of delivery. Odds ratio was calculated to measure the risk associated with extreme age. Those women who were <18 years of age attributed 3.2 odds of developing fetal complications and 3.9 odds of developing maternal complication whereas women >35 years of age attributed 3.7 odds of developing fetal and odds 10.7 developing maternal complications. Conclusion: Women in extreme age group were at a higher risk for developing adverse fetal and maternal obstetric complications as compared to their reference group.

Objectives:  To evaluate the frequency of reactive and clonal thrombocytosis based on age, sex, clinical findings, and severity of thrombocytosis. We also highlight the determination of hematological parameters for the diagnosis of these disorders required the management of thrombocytosis to reduce the morbidity and mortality rate. Methods: This descriptive experimental study was conducted in the Diagnostic and Research laboratory, Peoples University of Medical and Health Sciences, Nawabshah and department of Pathology, from July 2017 to June 2018. Total 325 patients including 260 patients with reactive thrombocytosis and 65 patients with clonal thrombocytosis, their age ranged between 12 and 45 years and 35 to 68 years were selected. The male to female ratio were 1.5:1 and 2.5:1 while clinical history and clinical examination were noted. The blood samples were taken from all these patients for the analysis of hematological parameters by a hematological analyzer (Nihon Corden) and an iron profile performed for assessment of iron status to confirm the diagnosis of iron deficiency anemia. The examinations of peripheral blood smears and bone marrow smears in the case of clonal thrombocytosis seen in chronic myeloid leukemia essential for the diagnosis. Results: The mean ages and male to female ratio among 325 patients with reactive and clonal thrombocytosis were 28.5 + 16.5, 51.5 +16.5 and 1.5:1, 2.5:1 ratio were found in this study. The mild to moderate thrombocytosis were found in reactive thrombocytosis while moderate to severe thrombocytosis was detected in patients with chronic myeloid leukemia. Conclusions: The frequency of thrombocytosis was higher in clonal thrombocytosis than the reactive type.