Objective: To highlight the rising trend of caesarean section and strategies to reduce the caesarean section rate in an urban setting. Methods: The qualitative, phenomenological study was conducted at the Lady Aitchison Hospital, Lahore, Pakistan, from October 16 to November 30, 2020, and comprised obstetrics and gynaecology practitioners principally responsible for making decisions related to caesarean sections.  Data was collected through face-to-face detailed interview with each subject. The interviews were transcribed manually and codes were formed that led to themes. Results: Of the 10 subjects interviewed, 1(10%) was the department head, 2(20%) were associate professors, 2(20%) were assistant professors and 5(50%) were senior registrars. Main indications of caesarean section in primigravida were foetal distress, failed induction, failure to progress, social demand, malpresentation, eclampsia and antepartum haemorrhage. There were 5-7 themes that fell under each of these seven codes. Conclusion: With proper implementation of uniform decision-making strategies, the rate of caesarean section in primigravida can be lowered with proper antenatal assessment, cardiotocographic monitoring, obstetric skills teaching, specialists; involvement in decision making and counselling of patients. Key Words: Caesarean section, Primigravida, Phenomenology, Analysis.

Background: Hepatitis E Virus (HEV) is the major cause of morbidity and mortality in pregnancy. The virus was detected about three decades ago. The incidence and severity during pregnancy vary widely around the world.Material & Methods: This observational retrospective study was conducted from March 2019 to February 2020 in Obstetrics & Gynecology Department of Lady Aitchison Hospital, Lahore. 70 pregnant women with hepatitis E were subjected to detailed history taking. The diagnosis was based on positive Hepatitis E IgM (Anti HEV IgM) antibody on laboratory test in current pregnancy in antenatal period up to 42 days post partum were included.Results: Out of 70 pregnant women with Hep E IgM+ve, 3 (4.3%) women had Obstetrical hysterectomy as complications, with mean age of 26.0 ± 4.69 years. The mean gestational age when infection occurred was 31.12 ± 5.18 weeks. Among all females 9 (13%) patients expired due to fulminant hepatic failure, 12 (17.14%) females gave birth via spontaneous vaginal delivery (SVD),17(24.2%) females gave birth via C-Section. 30 (42.8%) females were manage conservatively.Conclusion: Hepatitis E viral infection in pregnant females is a life threatening condition. The study showed that pregnant women with jaundice and hepatitis E virus infection had a high mortality rate during third trimester. Early diagnosis and management will help in the control of the disease and prevents its complications.

Abstract: Objective: To know the frequency of doctors with IgG antibodies positive for SARS-COV-2 working in Mayo hospital emergency during the COVID-19 pandemic Design: Observational Cross-Sectional study Sample size: 151 Methodology: Those doctors who gave consent for study were included. Demographical Variables, designation, area of work, history of symptoms of COVID-19, use and availability of PPE were asked on a performa. Blood samples were drawn for analysis by a local laboratory to assess levels of IgG antibody titer. Collected data was analyzed using SPSS 20. Results:The mean Age of 151 included participants was 27.94 ± 4.25. Of these , 96 (63.6%) were male and 55 (36.4%) were female. Mean IgG level was 2.09 ± 5.23. Seropostivity  for COVID -19 IgG antibody among doctors working at Emergency of Mayo hospital was  observed in 39.7 % (60).. 91 (60.3%) were screened negative. 63 (41.7%) doctors showed symptoms of COVID-19 of them 47 were screened positive and 16 were non reactive in antibody titer. Among 88 (58.3%) asymptomatic participants 13 (14.7%) were seropositive where as 75 (83.3%) neither showed symptoms nor showed reactive antibody titer. Conclusion: There was a high seroprevalance of antibodies against SARS-CoV -2 in doctors working at Mayo hospital, Lahore. Most of the symptomatic patients were seropositive. Key Words: SARS CoV-2, IgG antibodies, Seroprevalance

Introduction: Immunization strengthens the defense mechanism of the body and offers protection against potential diseases. The rate of immunization is one of the best measures of public health management and quality. To increase the rate of immunization, parental decisions about vaccinations are very necessary. Parents' knowledge and attitude towards immunization influence the prevalence of infectious diseases. Moreover, vaccination is considered one of the most cost-effective public health tools to prevent infectious diseases.Objective: The objective of this study is to assess the frequency of adequate knowledge, positive attitude and good practices of mothers regarding immunization.Materials and Methods: It was a cross-sectional study which was conducted in The Children's Hospital & Child Health Institute, Lahore. A total of 125 children who met the selection criteria were enrolled. Parents were then questioned and validated by vaccination card status regarding various Expanded Immunization Policy (EPI) vaccinations and complete previous records. The awareness and attitude of mothers regarding vaccination was also considered that either they were aware of the vaccination status or not. All the data was collected and reported in the form of a questionnaire.Results: In this study93 mothers had a good understanding, 77 mothers had a good practice, and 66 mothers had a positive attitude towards immunization. Childs’ gender, mothers’ educational status, socio-economic status, good practice, and positive attitude had no significant impact on adequate knowledge about vaccination.Conclusion: It was concluded from this study that mothers’ knowledge about immunization was adequate, however good practice and positive attitude were not up to the mark. Â

Background: Post Partum Hemorrhage (PPH) is a life threatening emergency that needs to be managed timely. Refractory PPH is treated surgically. Bilateral internal iliac artery ligation is one of the surgical procedures performed to control bleeding.Objective: We analyzed the effectiveness of Bilateral IIAL in controlling bleeding in PPHMethodology: It was a retrograde cross-sectional study conducted at Lady Aitchison hospital, Lahore from data during January 2018 to December 2020. After applying inclusion and exclusion criteria, data of patient including demographics, history, examination, ultrasound, procedure details and post-operative complications were recorded. All the data was analyzed using SPSS version 23.0.Results: All the patients (44) survived and success rate was 100 %. Uterine atony was present in 29 (65.9%) patients as a cause of PPH, placental abnormality, uterine rupture and coagulopathy in 7(15, 9), 4 (9.1%) and 4 (9.1%) patients respectively. 17 patients did not develop any complication. Most common Post-operative complication was wound infection (22.75%) followed by pneumonia (20.5%), paralytic ileus (9.1%) and DIC with renal failure (9.1%).Conclusion: Bilateral IIAL was found to be an effective and preferred life saving procedure, preserving fertility.