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Objective: The purpose of this analysis was to do the comparison of the effect of general anesthesia and spinal anesthesia on neonatal Apgar score in patients enduring elective cesarean section. Study design: A Randomized control trial. Place and duration: In the department of Anesthesia, pain and intensive care Divisional Headquarters teaching Hospital Mirpur Hospital for six-months duration from July 2021 to December 2021. Methods: In this study, 120 patients in the cesarean section operating room list were alienated into 2 equal groups. Group I (n = 60) were given spinal anesthesia and in group II (n = 60), general anesthesia was given. There was no significant difference in height, weight and age of patients. Patient information is recorded on the designed performa. Comparisons were made between groups I and II. Apgar scores were assessed 1 and 5 minutes after birth and recorded as proforma. Results: The patients mean age of the group-I was 30.04 ± 4.9 years and 29.81± 5.84 years in the group-II. The mean change between the groups was not statistically substantial (p = 0.66). The patients mean weight in the first group was 70.95 ± 10.31 kg and in the second group it was 73.50 ±11.28 kg. Infants born to women who received spinal anesthesia had a higher Apgar score at 1 minute and 5 minutes compared to females who were given general anesthesia (P <0.001). The highest proportion of patients in the first group exhibited better Apgar score than patients in the second group. Conclusion: Neonates of females who had cesarean section under spinal anesthesia had better APGAR score than under general anesthesia. Keywords: Apgar score, spinal anesthesia, general anesthesia, neonatal

Background: Abnormal uterine bleeding (AUB) is a common gynecological problem that affects the women of all ages. It is defined as any irregular or excessive bleeding from the uterus that is not related to the woman’s normal menstrual cycle. It can be caused by a many of underlying factors such as hormonal imbalance, fibroids, polyps or endometriosis. Study design: It is a randomized controlled study conducted at Divisional Headquarters Teaching Hospital Mirpur Azad Kashmir and Lady Willingdon Hospital Lahore for the duration of six months from June 2022 to November 2022. Material and Methods: The study was carried out for two groups. Intrauterine group included the patients that received intrauterine dose of progesterone and oral group patients had progesterone orally. The study was approved by the review board committee of the hospital. The use of pads for both groups was studied and it was found that oral group used the most pads 18.7 and 12.9 before and after the study respectively. Results: Duration of bleeding was examined. The patients in intrauterine group stated about bleeding for 7.8 days before the study and 5.9 days after the study. In case of oral group participants, they bled for 8.9 days before the study and 6.7 days after the study. Standard deviation and p value was calculated and results were statistically significant. Conclusion: The investigation of oral and intrauterine progesterone for patients suffering from dysfunctional uterine bleeding was studied and it was found that the rate of bleeding was more in case of oral group. Keywords: Intrauterine progesterone and oral progesterone.

Background: Despite the advances in the contraceptive technologies, still the unintended pregnancies are adding to the global health issues. The placement of a contraceptive device, such as an intrauterine device (IUD) or contraceptive implant, immediately after childbirth is termed as long-acting reversible contraceptives LARC. Study design: It is a retrospective study conducted at Lady Willingdon Hospital Lahore and Divisional Headquarters Teaching Hospital Mirpur, Azad Kashmir for the duration of six months from April 2022 to September 2022. Material and Methods: The study was approved by the health and ethical board committee of the hospital. The study was conducted on 102 patients that visited tertiary care center during a course of six months. The age of women ranged from 18 to more than 36 years. There were 51 women who belonged to age group 18-24 years, 32 were in the 25-35 year range and 49 were older than 35 years. Results: Standard deviation and p value was calculated and results were statistically significant. There were 8 women who were nulliparous, primipara women were 31 and 58 were multipara. There were 5 women that were included in the grand multipara group. There were 42 women that belonged to urban area and 60 lived in rural area. Most of the women 52 had primary level of education, however 24 had higher secondary level of education and 56 were working women. Conclusion: The acceptance rate was only 9% in the vaginal birth patients. The use of LARC could be an easy and cost effective contraceptive way. Keywords: Intrauterine device and family planning services.

Background: Abnormal uterine bleeding (AUB) is a frequent prenatal problem that affects the women of all ages. AUB is the condition in which vaginal bleeding occur in the absence of pregnancy. The most common and easily available imaging procedure is the ultrasonography. Our study aimed to investigate the correlation between sonographic findings and histopathological examination of hysterectomy specimens in perimenopausal women with AUB. Study design: It is a cross-sectional study conducted at Lady Willingdon Hospital Lahore and Divisional Headquarters Teaching Hospital Mirpur, Azad Kashmir for the duration of six months from July 2022 to December 2022. Material and Methods: This study on hysteroscopy was carried out on 50 patients suffering from uterine bleeding and having a biopsy. All the patients selected in the given study were according to the inclusion criteria, while those patients were excluded that do not fulfill the inclusion criteria. Most of the patients included in this study had ages between 31 to 41 years. The study was approved by the review and ethical board committee of the hospital. Results: Most patients having this ultrasonography had fibroid and bulky uterus. Only a few had Adenomyosis and thick endometrium. Neglectable patients had an endometrial polyp and malignancy issues. The sensitivity value for the normal endometrium used as a control was at an acceptable range and it was used as the control for the further evaluation of other attributes. Conclusion: For the diagnosis of abnormal uterine bleeding, hysteroscopy is an excellent diagnostic tool and it is highly efficient for the estimation of pathological issues of the endometrium wall. Keywords: Abnormal uterine bleeding, sonography and histopathological examination.