World Health Organization (WHO) recommends at least 6 months interpregnancy interval after an abortion. Pakistan has a low contraceptive prevalence rate and a high unmet need for contraception. Post-abortion women are the potential clients for contraception but national data reveal low uptake of the contraceptive methods by these clients. This study aimed to explore the barriers to adopting contraception among post-abortion clients in the district of Sargodha, Pakistan. A qualitative research design was used. Study participants were recruited from three private and three public sector hospitals in the district of Sargodha, Pakistan. The study was conducted from July 2018 to November 2018. Ninety-nine in-depth interviews (IDIs) of post-abortion women were conducted using an unstructured interview guide within the period of one month after abortion. Detailed field notes were made. Interviews continued until thematic saturation had reached. The content was organized into a matrix based on themes and sub-themes. A descriptive thematic analysis using both inductive and deductive coding was conducted. Reasons for not adopting contraceptive methods were explored Although many clients expressed a desire to limit fertility, some barriers were found to be hindering the uptake of contraception. Major barriers expressed by clients were the unwillingness of the husband, the resistance of other family members and real or perceived fear of side effects of contraceptive methods. Lack of adequate knowledge about fertility and contraception was another factor which contributed to the decision not to adopt contraception. Socio-cultural norms to have large family sizes were also reported by some clients. Other barriers include religious beliefs, focus on other health issues, financial unaffordability, infrequent intercourse and plan for tubal ligation. The study concluded that without addressing the barriers post-abortion contraceptive uptake is unlikely to improve. Identification of barriers is the first step to addressing the existing unmet need for contraception.

Background: Dysmenorrhea is an important health issue of young adult females that badly affects their quality of life and academic performance. This study aimed to determine prevalence, impact, management practices and factors associated with dysmenorrhea among medical students. Methods: This analytical cross-sectional study was conducted in Akhtar Saeed Medical & Dental College Lahore from August 2020 to December 2020. Using Cochran’s sample size calculator and rounding off, sample size of 400 female students was calculated. Convenience sampling technique was used. A self-constructed questionnaire was used which was designed after extensive literature search. Pain intensity was estimated using Visual Analogue Scale (VAS). Data were entered and analyzed in SPSS version 23. Chi square test was applied to find association between variables. A p-value of < 0.05 was considered statistically significant. Results. Mean age of participants was 21.07 ± 2.58 years. Prevalence of dysmenorrhea was 79.5%. Statistically significant association was found between dysmenorrhea and participant’s age (p value=0.002),  marital status(p value=0.001), family income(p value=<0.001), age of menarche (p value=<0.001), days of  bleeding (p value=0.009) and regularity of cycle(p value=<0.001). Mostly participants used combinations of remedies. Rest was the most commonly used remedy to relieve pain.  Impact of dysmenorrhea included social withdrawal, inability to prepare for exam, difficulty in carrying out daily activities and absence from college. Conclusion. Prevalence of dysmenorrhea was 79.5%. Statistically significant association was found between dysmenorrhea and participant age,  marital status, family income, age of menarche, days of  bleeding and regularity of cycle. Alone or together, taking rest was the most commonly used remedy to relieve pain. Dysmenorrhea negatively affected quality of life.

Objective:  The most prevalent type of skeletal TB, which accounts for nearly half of all cases, affects the spinal column. Regarding pain, neurological deficit, and spinal instability, the study sought to determine the surgical outcome of spinal tuberculosis. Material and Methods:  This study was conducted in the Department of Neurosurgery, Ayub Teaching Hospital. A total of 42 patients with ages ranging from 24 – 66 years were included in the study. Information about the patient was gathered to determine indications (neurological impairments) about the ASIA Grading Scale and frequently affected areas. Results:  Commonest location was a thoracolumbar junction in 42.8%, followed by the lumbar spine in 23.8%. The pain was found in all subjects. The main indication of surgery was neurological deficit which is seen in 57% of patients followed by spinal instability or deformity in 16.6% of patients and patients with failed chemotherapy in 4.7% of patients. The preoperative KA was between 30 – 60º with a mean of 43.06 ± 4.11 degrees and 9.45 ± 3.99 degrees for postoperative KA (p-value < 0.0001). Most fixations of the cord were done through a posterior approach that was in 83.3% of patients. The neurological improvement according to ASIA grading was seen in 95.2% and no improvement was seen in 4.7% of patients upon 3 months follow-up. Conclusion:  Surgical treatment of the caries spine improves pain, lowers neurological compression, and successfully reverses deformities like kyphosis, resulting in better clinical results. It also helps to remove the Tuberculous burden from the body.

Background: Diarrhea is the second major cause of mortality in children worldwide. Timely interventions by caregivers who are mainly mothers, can contribute towards a favorable prognosis of this condition in children. Aim: The purpose of conducting this study was to assess maternal knowledge and the practices regarding prevention of diarrheal diseases in children under the age of 5 years. Setting: This study was carried out in three hospitals at Lahore, Pakistan. Methods: An analytical cross-sectional study was conducted from January to July 2020 and a convenience sampling technique was used for data collection. Data was collected from 158 mothers of children under 5 years of age by using a self-structured, pre-tested questionnaire. Chi square test was applied and p-value <0.05 was taken as significant. Results: A total of 158 mothers responded to the study questionnaire; mean age of the participants was 28.4+ 7.6 years, 22.8% were illiterate, 84.2% were housewives, and 37.4% had income more than 31000 rupees/month. The majority (43.1%) had ‘poor’ knowledge, 24% had’ poor’ attitudes and practices while 12% had better practices. Significant associations were observed between mother’s knowledge with education (p-value=0.004), income (p-value=0.001), frequency of diarrhea in a child (p-value=0.053) and practices with education (p-value =0.039). Conclusion: This study showed the direct relationship between mother's literacy level and family income with better knowledge and feeding practices of children regarding prevention of diarrhea. It has highlighted the role of mothers in the management of acute diarrheal diseases.