Objectives: To determine the prevalence of anemia in pregnant women attending antenatal clinic and to asses the cause of anemia. Study Design: Temporal sampling technique. Place and Duration of Study: Antenatal clinic Unit II, Department of Obstetrics and Gynecology of Services hospital, Lahore from 01.03.2001 to 01.03.2002. Subjects and Methods: Hemoglobin estimation was done in all subjects. Blood indices, peripheral smear, malarial parasite and stool examination were carried out in women with values less than 11gm/dl. Serum electrophoresis was done if the hemoglobin was less than 7gm/dl. Results: It was found that 66% of the pregnant women were anemic. Anemia was more common in women with lesser education, low socioeconomic group and increasing parity. Iron deficiency anemia was found in 72.7% of anemic women. Conclusion: Effective steps should be taken to diagnose anemia early in pregnancy.

Objective: To compare the intraoperative blood loss and adhesions, peri-operative blood and intravenous iron supplementation between hepatitis seropositive and seronegative pregnant women undergoing elective cesarean delivery. Study Design: Cross-sectional, analytical study. Place and Duration of Study: Departments of Anesthesiology and Gynecology & Obstetrics, Combine Military Hospital, Okara Cantt Pakistan, from Oct 2018 to Mar 2019. Methodology: After approval of the hospital ethical committee, 134 (n=67 in each Group) pregnant women were included in our study by convenient sampling. Patients were divided into two groups. Group-A included seronegative pregnant women, whereas Group-B were seropositive pregnant women. Results: There was no difference in the age (p=0.357), gravidity (p=0.159), parity (p=0.226) and the number of cesarean sections (p=0.475) between the two groups. There was no difference in the two groups regarding peri-operative haemoglobin change,with an insignificant reduction of 0.60±1.21 g/dL in Group-A versus a reduction of 0.50±1.08 g/dL in Group-B. A mild level of adhesion was observed intraoperatively in 26(35.6%) in Group-A versus 27(37.5%) in Group-B; p=0.170. Mild difficulty securing hemostasis was reported in 25(34.2%) vs 29(40.2%) patients; p=0.329. 61(83.5%) did not require a peri-operative blood transfusion in Group-A versus 59(81.9%) in Group-B; p=0.528. Conclusion: Our study has shown that the peri-operative haemoglobin level, blood product and intravenous iron supplementation, intra-operative adhesions encountered, and difficulty in hemostasis were comparable between sero-positive and sero-negative viral hepatitis pregnant women.

Objective: To compare the efficacy of clomiphene citrate and clomiphene citrate with metformin in anovulatory infertility with PCOS (polycystic ovarian syndrome (PCOS). Study Design: Randomized controlled trial. Place and Duration of Study: This research took place in the Department of Gynecology and Obstetrics at the combined military hospital Bahawalpur. The study was carried out over a six-month period, starting on 1st November 2022 and concluding on 30 April 2023 Materials and Methods: The study comprised 176 married women aged between 18 and 40 years who had been experiencing anovulatory infertility and PCOS for more than 6 months. In group A, for a period of three menstrual cycles, patients received 500 mg of metformin three times a day consistently and 100 mg of clomiphene citrate daily from the fifth to the ninth day of their menstrual cycle. In contrast, patients in group B were given 100 mg of clomiphene citrate daily from the fifth to the ninth day of their menstrual cycle for up to three months. We recorded and analyzed the treatment efficacy for all participants in both groups. Results: In this study, the metformin and clomiphene combination showed a 71.59% ovulation rate compared to clomiphene alone (39.77 %). The pregnancy rate was 31.82% with clomiphene citrate (CC) and 64.77% with a combination (clomiphene citrate and metformin). Efficacy in the study was observed in 57 (64.77%) patients treated with metformin and CC. group and 28 (31.82%) patients in the clomiphene citrate alone group (p = 0.002). Conclusion: The findings from this study suggest that the combination of clomiphene citrate and metformin demonstrated superior efficacy compared to the use of clomiphene citrate alone in treating anovulatory infertility associated with polycystic ovary syndrome. Keywords: Polycystic ovarian syndrome, clomiphene citrate, metformin.