Objective: To observe the role of Mentzer index for differentiating iron deficiency anemia (IDA) and beta thalassemia trait (β TT) in pregnant women. Methods: This cross-sectional study was conducted in Gynaecology & Obstetrics Department of Nishtar Medical University from October 2020 to March 2021. Non-consecutive sampling was applied. A total of 100 antenatal ladies with hemoglobin <11 gm/dl were included. Their complete blood counts were checked and Mentzer Index was calculated. Mentzer Index <13 points to diagnosis of β TT and >13 indicates IDA. The diagnoses were confirmed by serum iron studies and Hb electrophoresis. The sensitivity and specificity of Mentzer Index for both causes of microcytic hypochromic anemia was calculated. Results: Out of total 100 patients with microcytic hypochromic anemia, 87 had Mentzer Index >13 and IDA was confirmed in 86 out of 87 cases. Thirteen cases had Mentzer Index <13 and β TT was confirmed in eight of them. Thus, Mentzer Index has a sensitivity and specificity of 91% & 83% for IDA and 83% & 91% for β TT. Conclusion: In this study, it was found that Mentzer Index can be used as a discriminatory test to differentiate between iron deficiency anemia and beta thalassemia trait. The high risk group can then be subjected to definitive diagnostic tests. This can result in better patient compliance and cost effectiveness. doi: https://doi.org/10.12669/pjms.38.4.4635 How to cite this:Tabassum S, Khakwani M, Fayyaz A, Taj N. Role of Mentzer index for differentiating iron deficiency anemia and beta thalassemia trait in pregnant women. Pak J Med Sci. 2022;38(4):---------. doi: https://doi.org/10.12669/pjms.38.4.4635 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Infertility is global health issue. Male factor contribute to infertility in more than half of sub fertile couples. Their diagnosis is easy by simple test of husband semen analysis. This study has been designed to know the contribution of male factor and frequency of abnormalities of semen in infertile couple. Objectives: To determine the frequency of male factor in infertile couple and to evaluate the different abnormalities in semen. Study Design: Descriptive study. Setting: Department of Obstetrics and Gynecology in Nishtar Hospital Multan. Period: From January 2019 to June 2019. Material & Methods: Study started after taking approval from hospital ethical committee. Study included 200 subfertile couples after informed consent attending the outpatient department. The partner of female attending the fertility clinic between ages 20-40 were selected. History taken from female partner regarding age, duration of subfertility, type of subfertility any drug intake and medical illness of male. Result: Among 200 couples 64(32%) had abnormal semen parameters.24 had oligospermia. Eight had azoospermia and 60 had asthenospermia. 20 patients had teratospermia. Conclusion: Male factor is significant contributor of infertility therefore awareness is needed in order to engage more males partner in evaluation and management of infertility.

Objective: To compare mean hemoglobin levels of neonates after early and late cord clamping. Study Design: Randomized Controlled Trial. Setting: Department of Obstetrics & Gynaecology at Nishtar Hospital Multan. Period: June 2019 to December 2019. Material & Methods: A total of 60 women booked and unbooked were included in study. Selected patients randomized into group A and B, each group comprising of 30 patients depending upon the envelope with assigned treatment (either early or delayed cord clamping) picked up by the patient. Results: In present study, two groups were made. Group A consisted of 30 neonates in whom early cord clamping was done while in group B delayed clamping was done in 30 neonates. Mean age of mothers was 28.4±0.4 vs. 28.6±0.5 years in group A and B respectively. There were 25 mothers (83.3%) in group A and 21 mothers (70%) in group B between 25–30 years. There were 5 mothers (16.7%) in group A and 8 mothers (26.7%) in group B between 31–35 years of age. While none of the mother in group A and 1 mother (3.3%) in group B was between 36–40 years of age. Mean parity of the mothers was 1.1±0.2 vs. 1.4±0.2 in group A and B respectively. Eight mothers (85.4%) in group A and 7 mothers (82.5%) in group B were primipara. While 22 mothers (14.6%) in group A and 23 mothers in group B (17.5%) were para 1–3. Gestational age was 37–38 weeks in 13(43.3%) vs. 19(63.3%) women in group A and B respectively. While there were 17(56.7%) vs. 11(36.7%) women in group A and B respectively of the gestational age 39–40 weeks. Pre-delivery maternal mean hemoglobin levels was 11.9±0.1 gm/dl vs. 12.3±0.1 gm/dl in group A and B respectively. Pre-delivery maternal hemoglobin levels were 10–10.9 g/dl in 2 mothers (6.7%) vs. 1 mother (3.3%) in group A and B respectively. Neonatal mean hemoglobin levels were 16.8±0.2 g/dl vs. 17.7±0.1 g/dl in group A and B respectively. Out of the 31 booked mothers, neonatal mean hemoglobin level was 16.8±0.2 g/dl vs. 17.9±0.1 g/dl in group A and B respectively. While out of the 29 unbooked mothers, neonatal mean hemoglobin level was 16.7±0.2 g/dl vs. 17.5±0.1 g/dl in group A and B respectively. When compared the neonatal mean hemoglobin levels, there was significant difference between mean hemoglobin levels of neonates between the two groups (p=0.000). Conclusion: Delayed cord clamping in term neonates for a minimum of 2 minutes at birth is beneficial to the newborn in terms of improved hemoglobin levels. There is no significant difference seen in pre-delivery maternal hemoglobin levels and neonatal hemoglobin either in delayed cord clamping group or in early cord clamping group.

Background:Ketamineisalreadyinuseinthenebulisedform,forattenuatingPOST,Dexmedetomidine,ontheotherhandis known to cause sedation and analgesia. The aim of our study was to assess the respective incidence and severity of POST and compare the effectiveness of nebulised dexmedetomidine and nebulised ketamine in reducing or alleviating POSTin adult patients undergoing thyroidectomy under GA. Method:Aprospective,randomized, double-blinded, comparative studywas conducted on a total of 96 patients,further divided into two age and gendermatched groups, in Super Specialty Hospital, GMC Jammu, over a period of 1 year. Patients in the age group of 18-60 years, who were scheduled to undergo elective thyroid surgery under general anaesthesia (GA) with endotracheal intubation, were included in the study. First group received ketamine 50mg (1mL) with saline (4mL) nebulisation and second group received dexmedetomidine 50µg (1mL) with saline (4mL) nebulisation. Results: No signicant difference in the mean age (in years), mean weight, gender ratio and duration of surgery between the two groups. Incidence of POST was 14.58% (7/48) in ketamine and 16.66% (8/48) in dexmedetomidine group, at 2 Hour interval. Severity was moderate for two patients in each group at 2 hour interval. POST persisted for a longer duration in Ketamine group as compared to Dexmedetomidine group. Signicant reduction in the severity of sore throat in both groups at all time points during 24 Hours. Conclusion:NebuliseddexmedetomidinemaybeconsideredasasafealternativetonebulisedketamineforalleviatingPOST

Objectives: To find out the pattern of female gynecological malignancies in Pakistan, with the aim of providing basis for the development of preventive strategies to combat the current trend. Study Design: Observational study. Setting: Department of Oncology, Nishtar Medical University, Multan, Pakistan. Period: 1st January 2015 to 31st December 2019. Material & Methods: A retrospective analysis of all the cases of female gynecological malignancies presented was carried out using a proforma. The data was analyzed using frequencies and percentages. Results: The gynecological malignancies are the fourth (20.64%) most common female malignancies. Among gynecological cancers; ovarian cancer (47.1%) is the commonest, followed by cervical cancer (24.8%), uterine cancer (11.6%), gestational trophoblastic neoplasia (12.9%), vaginal cancer (2%) and vulval cancer (1.6%). Conclusion: Gynecological malignancies constitute a major portion of female malignancies. The need of the hour is to design effective preventive and control strategies, so as to lower the burden of female gynecological malignancies in future.