Objective: To determine pregnancy outcome in COVID-19 suspected and confirmed women presenting to a tertiary care hospital. Methods: An analytical study comparing clinical outcome of confirmed COVID-19 with suspected COVID-19 pregnant women was carried out during three-month period from 1st July to 30th September 2020 at COVID-19 ward on pregnant women of Sir Ganga Ram Hospital Lahore. Information including clinical features, obstetrical outcome, ventilatory support and mortality was collected on a predesigned Proforma. The data were analyzed by using SPSS version 24. Qualitative data were expressed as frequency, percentages and chi-square, While quantitative variables as mean ± SD. Results: Eighty-three patients were enrolled, including 41 confirmed and 42 suspected COVID-19 cases. The mean age was 28.59 years +4.9. The mean gestational age on admission was 31.98 weeks. Obstetrical complications included miscarriage in 5 (11.6%) cases, preterm labor in 5 (11.6%), PPROM in 1 (2.3%) and IUD in 2 (4.7%) in COVID-19 suspect group. A total of 17/41 confirmed and 19/42 suspected COVID-19 were delivered during the study mostly through caesarean section. Supplemental oxygen, ICU admission, and invasive mechanical ventilation were more common in COVID-19 suspect group compared to confirmed COVID-19 group. There were 12(28.5%) mortalities in COVID-19 suspect group as compared to 2/41 (4.8%) in confirmed COVID-19 group. Conclusion: In patients having epidemiological exposure, clinical features of COVID and suggestive chest X-ray/CT chest findings even with negative COVID-19 PCR, high index of suspicion of COVID-19 must be mainstay to prevent delayed management and disease spread till the availability of more sensitive test.

Small ubiquitin-like modifier (SUMO) fusion technology is widely used in the production of heterologous proteins from prokaryotic system to aid in protein solubilization and refolding. Due to an extensive clinical application of human bone morphogenetic protein 2 (hBMP2) in bone augmentation, total RNA was isolated from human gingival tissue and mature gene was amplified through RT-PCR, cloned (pET21a), sequence analyzed, and submitted to GenBank (Accession no. KF250425). To obtain soluble expression, SUMO3 was tagged at the N-terminus of hBMP2 gene (pET21a/SUMO3-hBMP2), transferred in BL21 codon+, and ~ 40% soluble expression was obtained on induction with IPTG. The dimerized hBMP2 was confirmed with Western blot, native PAGE analysis, and purified by fast protein liquid chromatography with 0.5 M NaCl elution. The cleavage of SUMO3 tag from hBMP2 converted it to an insoluble form. Computational 3D structural analysis of the SUMO3-hBMP2 was performed and optimized by molecular dynamic simulation. Protein-protein interaction of SUMO3-hBMP2 with BMP2 receptor was carried out using HADDOCK and inferred stable interaction. The alkaline phosphatase assay of SUMO3-hBMP2 on C2C12 cells showed maximum 200-ng/ml dose-dependent activity. We conclude that SUMO3-tagged hBMP2 is more suited for generation of soluble form of the protein and addition of SUMO3 tag does not affect the functional activity of hBMP2.

OBJECTIVES: To find out the frequency of obstetric hysterectomy, its indications and associated maternal complications in a tertiary care hospital of Lahore, Pakistan. METHODOLOGY: This is a retrospective observational descriptive study. It was done in Department of Obstetrics and Gynaecology of a Tertiary Care Hospital, Lahore from Feb 2015 to Jan 2016. All the records of patients, who had undergone hysterectomy, within 24 hours of normal delivery or caesarean section, were reviewed. The details of age, parity, booking status, indication and Complications of operation were recorded on a predesigned proforma. RESULTS: The total deliveries during the period were 5, 754. Obstetric hysterectomy was performed in 26 patients. This gives frequency of the emergency obstetric hysterectomy in our unit to be 4.5/1000 births. The major indication was previous caesarean sections with placenta previa and/or accreta in 17 cases (65.38%), followed by massive postpartum haemorrhage due to uterineatony in 4 cases (15.38%), uterine rupture in 3(11.5%) and abruption placenta in 2 (7.6%). Most common complication was haemorrhagic shock seen in 14 patients. There were 5 cases of bladder injury, 2 Ureteric injury and 2 vault hematomas. Maternal deaths occurred in 3 cases. CONCLUSION: Emergency obstetric hysterectomy is increasing with increased frequency of caesarean sections and placenta previa and accreta. Antenatal booking of high risk patients, timely referral to tertiary care hospital with good surgical expertise and ICU care can reduce morbidity and mortality in such cases.

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Objective: To determine contraceptive knowledge and practices among multiparous women. Study Design: Cross Sectional, Multicenter study. Setting: Gynae Unit I of Sir Ganga Ram Hospital, Lahore and Gynecology Department of Government Teaching Hospital, Shahdara. Period: 1st July 2019 to 31st December, 2019. Material & Methods: A total of 448 multiparous women were randomly selected from 2 tertiary care hospitals. A structured questionnaire was used to assess the knowledge of women attending antenatal and gynaecology clinics and indoor. Results: Out of 448 women, all were aware of at least one method of contraception and 272 (65%) had used one. The most commonly employed method was male condom (33%) followed by IUCD (24%), oral contraceptive pill (22%) and hormone based injectables (13%). In upper socioeconomic class, 95% were using birth control methods whereas 71% of middle class and 48% of lower class subjects had used any one method of birth control. In the highly educated subjects, 67% had employed a contraceptive method and among the illiterate, only 39% has used any method. Disapproval on part of the husband was the most common (28%) reason of refusing contraceptive services, followed by desire for more children (16%). Health care workers were the most common source of knowledge of contraception (69%) followed by family members (31%) and media (17%). Conclusion: All the subjects were aware of contraceptive methods. The most common used method is condoms followed by IUCD but practices were limited due to high illetracy, lower socioeconomic status, partener refusal, desire for more issues and fear of side effects.