BACKGROUND & OBJECTIVE: Iron deficiency results in major disabilities and death all over the world, about two billion people are suffering from anaemia at the moment. To compare intravenous iron sucrose with intravenous ferric carboxymaltose in terms of mean change in hemoglobin level and mean corpuscular volume (MCV) for treatment of iron deficiency anaemia in pregnant patients. METHODOLOGY: Prospective comparative study was conducted at the department of Obstetrics/ Gynecology of POF Hospital Wah Cantt and HIT Hospital Taxila Cantt. The study duration was 2 years, from January 2017-December 2018. A total of 80 patients were included in the study. Patients were randomly divided into two groups; in Group-A; 40 patients were given intravenous iron sucrose, and in Group B, 40 patients were given intravenous ferric carboxymaltose. Patients were observed for hemoglobin level and mean corpuscular volume (MCV). Data analysis was done with SPSS version 24. An Independent t-test was applied, and results with p-value ≤0.05 were found significant. RESULTS: Post-treatment hemoglobin means level in the iron sucrose group was 9.90±0.4SD, and in the intravenous ferric carboxymaltose group, post-treatment hemoglobin was 10.71±0.9SD (p≤0.001). In the iron sucrose group, the post-treatment mean corpuscular volume mean level was 81.94±6.0SD and in the intravenous ferric carboxymaltose group mean post-treatment mean corpuscular volume was 88.08±7.1SD (p≤0.001) CONCLUSION: Treatment with intravenous iron caboxymaltose is superior to intravenous iron sucrose with respect to hematological response, which seems to be safe, as very few severe side effects were observed.

Aim: To assess the efficacy of reflective activities in obstetrics and gynecology residents for improving certain recognized abilities. Methods: Continuously communicate permission, twenty-five patients from across all five years of the residency program have been included in the research. Surgical skills, professionalism, communication skills, and especially analytical thinking abilities were recognized as competencies. The introspective activities were evaluated using a foundation for the rest designed for this purpose. Results: The findings revealed that the resident’s capacity to participate in intentional reflecting activities was originally weak, but improved with practice and yielded promising results. In comparison to others made up to the mark, reflective exercises were very beneficial in improving training and expertise. Conclusion: Regularly engaging postgraduate trainees in intentional reflecting activities have yielded good outcomes in terms of growth in surgical, communicative, and quality assessment abilities, as well as a role in enhancing professionalism amongst residents. Prospective multicenter research, on the other hand, can provide more information about the efficacy of such a therapy. Keywords: Reflective Activities, Obstetrics and Gynecology, Residents.

Background: Shivering is a normal physiologic protective mechanism of the body, which in response to core hypothermia, increases metabolic heat production that results in involuntary, oscillatory muscle activity. Spinal anesthesia promotes redistribution of body heat from central to the peripheral compartments. After spinal anesthesia shivering occurs in 40-60% of patients. Tramadol is synthetic codeine analog that is weak Mu opioid receptor agonist. It also has effect of norepinephrine and serotonin reuptake inhibition. It proves to be more effective in prevention and treatment of shivering and it also has less side effects then Mu opioid agonists. Objective: To compare the outcome of hyperbaric bupivacaine alone, with combination of hyperbaric bupivacaine and tramadol to prevent frequency of shivering in spinal anaesthesia. Study Design: Randomized clinical trial study. Place and Duration of Study: Department of Anaesthesiology & Gynaecology, POF Hospital, Wah Cantt, HIT Taxilla and Izzat Ali Shah Hospital, Wah Cantt from 1st December 2018 to 31st December 2020. Methodology: One hundred and 100 patients were included and divided into two equal groups. Patients in Group A received 2ml of 0.75% hyperbaric bupivacaine (15mg) and group B received 2ml of 0.75% hyperbaric bupivacaine (15mg) and preservative free tramadol (10mg, 0.2ml) in spinal anesthesia. Results: There were 13 (26%) female patients in group A and 37 (74%) male patients. In group B there were 35 (70%) male patients and 15 (30%) female patients. The mean age in group A was 42±8.05 years and 42±8.02 years in group B. Thirty two (64%) in whom shivering was present and 18 (36%) no shivering accrued in group A while in group B, 11 (22%) in whom shivering was present and 39 (78%) no shivering accrued (P<0.05). Conclusion: Post-anesthetic shivering appeared to be present in post spinal anaesthesia patients very commonly. Administration of tramadol has proved to significantly reduce incidence of shivering. More studies still need to be done on tramadol to confirm its efficacy in preveting and stopping shivering without systemic effects on patients. Keywords: Spinal anaesthesia, Bupivacaine, Tramadol, Shivering

Aim: To compare the adequacy of Pap-smear in the same patient obtained by Ayer’s spatula and cytobrush. Study design: Comparative cross-sectional study Methodology: One hundred and fifty patients were enrolled. Each patient was subjected to both the tools i.e. cytobrush and Ayer’s spatula. Results: The mean age was 41.6±10.4 years. 83.3% of patients using Ayer’s spatula while 94.7% was using cytobrush and statistically the significant (P=0.002) results were found. Conclusion: Sampling with cytobrush resulted in better percentage of adequate samples as compared to Ayer’s spatula. Keywords: Cervical cancer, Cervical cancer screening, cervical cancer screening techniques