Introduction: Testicular biopsy is an invasive diagnostic tool to evaluate spermatogenesis and has to be performed only following strict criteria. Objective: To compare open testicular biopsy and testicular fine needle aspiration (TEFNA) for spermatogenesis in terms of Johnsen’s scoring in patients with suspicion of obstructive azoospermia. Materials and Methods: This comparative study was conducted in Pathology department, Ghulam Mohammad Mahar Medical college, Sukkurduring 2021 to 2022. Detailed history was taken and physical examination was carried out including examination of external genitalia. Amongst them, men with normal testicular size and bilaterally palpable vas deference were investigated further regarding their hormone profile (FSH, LH, and Testosterone) and scrotal color doppler ultrasound (CDUS). Procedure was performed under local anesthesia (Spermatic cord block). Results: The mean age of patients in our study was 38.9±6.4 year with minimum age as 28 and maximum as 50 year. In this study, ages were categorized in two groups; one is 20-35 years age group and second is 36-50 years age group. There were 14(35.0%) patients in 20-35 years age group, while 26(65.0%) in 36-50 years age group. Practical implication: This article will helps to improve the technique for confirmation of presence of mature sperms. Conclusion: TEFNA is more reliable and minimal invasive technique for confirmation of presence mature sperms in men with obstructive azoospermia and is associated with minimal complications. Keywords: TEFNA, Sperms, Azoospermia, Complications

Objective: The purpose of this research was to better understand the factors that lead to pre-donation deferral at a tertiary care hospital's Blood bank. Understanding the factors that lead donors to decline can inform more effective selection criteria. Study Design: Cross-sectional/Descriptive study Place and Duration: Diagnostic and research laboratory Liaquat university of Medical and Health Sciences Jamshoro Hyderabad. January 2022-December 2022 Methods: This study comprised of 2200 donors at blood bank of LUMHS. The UDHQ included 25 questions to assess donors' backgrounds in regards to things like injections, medicines, time since last donation, tattoos, general health, dental work, sexual relationships, malaria/T.B., surgery, jaundice, vaccination, positive viral markers, etc. Haemoglobin (Hemacue 50/Diaspect Hb with daily quality control), Heart rate/rhythm, Blood pressure, Body temperature, Weight/Height, and Jaundice were all part of the physical exam. Results: There were majority 1578 (71.7%) males and 622 (28.3%) female donors among all cases. Donors mean age was 26.12±9.88 years and mean weight was 61.3±8.49 kg. 1435 (65.2%) cases were from urban areas. Among all, 1650 (75%) donors were accepted and 550 (25%) donors were deferral. Most common cause of deferral was low hemoglobin followed by anemia, HCV, HBV, inappropriate pulse rate, low BP, jaundice, active infection, malaria, syphilis, allergy, aspirin intake, drugs, last donation, skin/eye colour and sexual relationship. There were 1870 (85%) cases of replacement donors among all cases. Conclusion: The selection of healthy blood and the reduction of donor injury will be made possible by a thorough pre-donation screening interview and physical examination. Our setup has a somewhat higher blood donor deferral rate because to stringent donor sector requirements and extra attention paid to donor selection processes. The increased replacement donor deferral rate is a result of refusals for past injection history and poor hemoglobin levels. Keywords: Donors, Deferrals, Hemoglobin, Infection, HCV

Objective: To find an association between estrogen and progesterone with ovarian cancer progression. Study Design: Cross-sectional study Place and Duration of Study: Department of Obstetrics & Gynaecology, Islam Teaching Hospital, Sialkot from 1st January 2021 to 31st December 2021. Methodology: One hundred participants were enrolled. Ovarian cancer women were placed in Group A while healthy woman in Group B. The study was approved from the review board. The age of the patients was between 18-45 years. Demographic details as well as clinical and relevant familial history was documented of each patient. The blood sampling was done on same menstrual day 12 in each patient. Each patient 4 cc blood was withdrawn for analysis if their estrogen and progesterone levels. The blood was collected in serum vials and serum was separated by centrifugation at 3000rpm. The patients who were confirmed for ovarian cancer CA 125 were confirmed through clinical diagnosis in addition to their MRI and CT scan imaging. Results: The mean age of the patients was 33.3±2.1 years of ovarian cancers while 21.5±3.4 years of normal controls. Majority of the females were from low socioeconomic class. The values of progesterone and estrogen were significantly higher in CA 125 cases such as Group A in comparison with group B respectively. The analytes were assessed in the follicular phase and showed higher frequency in 96% and 94% of cases with ovarian cancer. The mean value was 2±0.4ng/ml and 119.1±2.9 pg/ml respectively. Conclusion: In ovarian cancer, level of estrogen was very higher during follicular phase. Keywords: Ovarian cancer, Advanced epithelial cancer, Estrogen, Progesterone, Abnormal secretion

Objective: The goal was to determine if antiplatelet medication was effective at preventing preeclampsia in high risk patients as well as its negative effects. Study Design: Descriptive case series Place and Duration: Gynaecology and obstetrics department LUMHS Jamshoro. Jan 2022-Dec 2022 Methods: Total 135 pregnant females of age 20-40 years were included in this study. The included patients were all high risk pregnancies with parity 5, gestational age 12 weeks, and hospital prenatal checkups. Aspirin (an antiplatelet medication) 120 mg/day was administered to all the females. They were monitored in the OPD up until the 36th week of pregnancy. Preeclampsia was diagnosed in females who had BP > 140/90 mmHg and proteinuria > 300 mg using the urine dipstick technique. All data were examined using SPSS 24.0. Results: There were 95 (70.4%) cases had age <30 years and 40 (29.6%) females had age >30years. Mean parity of the females was 2.3±5.11. Mean BMI was 25.02±6.35 kg/m2. There were 60 (44.4%) females were educated and 55 (40.75) females were from urban areas. History or preeclampsia found in 7 (5.2%) cases. There were 28 (20.7%) females were obese, chronic hypertension found in 9 (6.75) cases, gestational hypertension in 92 (68.1%) cases and gestational diabetes in 22 (16.3%) cases. Frequency of preeclampsia was found in 19 (14.1%) cases. Other complications were low platelet, acid peptic disease and Antepartum haemorrhage. Conclusion: We observed that the occurrence of preeclampsia was extremely low among high-risk females who had 120mg of Aspirin (antiplatelet medication) in the first trimester, but that the negative effects of antiplatelet therapy increased with increasing doses. Keywords: Pregnant females, Gestational Hypertension, Antiplatelet Therapy, Preecplampsia

Background: Genital herpes is the most common genital tract infection that results into high rate of morbidity and mortality of neonates on vertical transfer and also of females. Objective: To evaluate the management policies/techniques for HSV infection during gestation period. Study Design: Retrospective study Place and Duration of Study: Department of Obstetrics & Gynaecology, AJK Medical College Muzaffarabad Azad Kashmir from 1st January 2021 to 30th June 2021. Methodology: Sixty females were enrolled within the age of 21-39 years who were pregnant and having complete clinical symptoms of sore-vesicle clusters and minimal ulceration. 4cc blood was withdrawn with division into 2cc whole blood for PCR testing and 2 cc into serum for viral antigen detection through ELISA based kits against HSV 1 and HSV 2 antigens. Results: The mean age of 31.0± 4.2 years and majority of the women 48.3% were within the age of 34-39 years. The management therapy was found efficient in women suffering from herpes simplex virus 91.6% reduction found on polymerase chain reaction (PCR) reporting. Within the HSV 1 and HSV 2 pregnant women spontaneous delivery was observed in 24 (40%) women while rest 36 (60%) underwent cesarean delivery Conclusion: Genital herpes infection can be managed and treated by using antiviral medications and through cesarean deliveries in majority of the participants. Keywords: Genital herpes, Cesarean, Transmission, Neonates