<p><strong>Background and Objective:</strong></p> <p>Domestic violence has been identified as a very serious problem that affects women and children at all levels of society, regardless of race, financial status, religion, and level of education. Domestic violence in Pakistan is a very sensitive issue keeping in mind the psychological, religious, and social aspects. The aim of the study was to assess the level of knowledge and perception about domestic violence amongst gynecologists working in the tertiary care teaching hospitals of Lahore city, Pakistan.</p> <p><strong>Methods:</strong></p> <p>It was a cross-sectional survey study carried out among the doctors working in the Gynecology departments in different tertiary care teaching hospitals of Lahore. A total of 154 doctors of the Gynecology departments participated in this study.</p> <p><strong>Results:</strong></p> <p>Most of the participants (53.4%) had suboptimal knowledge regarding the screening tools for domestic violence against the women reporting in Gyneacology clinics. A significant association was found between awareness regarding domestic violence and an agreement for introducing a formal training course (P&lt;0.05). &nbsp;</p> <p><strong>Conclusion:</strong></p> <p>The knowledge and perception of health care providers to screen the cases of domestic violence is the basic key to identify such victims. However, a proper training of the staff handling such patients needs to be implemented at Government level.</p>

Background: Globally, Post abortion and pregnancy complications such as sepsis, hemorrhage and hypertensive diseases are the prominent bases of maternal mortality. Post-abortion family planning and effective treatment for unintended pregnancies could provide high quality post-abortion care. Limited data available in Punjab, Pakistan regarding post-abortion care services in health system. Aim: The purpose of the current study was to evaluate the post-abortion care services in health care system of Punjab, Pakistan. Materials and Methods: This cross-sectional study was carried out on 226 post-abortion patients of multi health care centers of Punjab, Pakistan from November 2020 to April 2021. Individual’s history, age, demographic characteristics, reproductive history, post-abortion attitude were surveyed using pre-designed and structured questionnaire. Also, post-abortion care such as pain management, treatment cost, waiting time, service confidentiality, contraceptive device cost, and patient’s interaction as well as family planning were assessed. Stata software was used for data analysis. Results: Of all the post-abortion cases, 207 (91.6%) were found satisfactory regarding post-abortion care. Effective pain management during treatment, treatment cost affordability, proper waiting time (< 0.5 hours), patient’s effective interaction, service’s confidentiality, and premises cleanliness were statistically significant when correlated with satisfied women (p-value<0.001). Conclusion: Our study found higher prevalence (91.6%) of post-abortion care satisfied women. However, effective treatment and regular follow-up should be assured for management of post-abortion complications such as services confidentiality, pain management, patient’s interaction and client’s optimal satisfaction with services. Keywords: Assessment, Post-abortion care, Health facilities

<p>Background and Objective: The discrimination between benign and malignant adnexal masses is important for clinical management and surgical planning in such patients. The risk of malignancy index (RMI) is a combined parameter that is a simple, highly sensitive, and more specific scoring system based on three factors: serum cancer antigen 125 (CA-125) levels, ultrasonographic (USG) score, and menopausal status. The objective of the study is to evaluate the diagnostic efficacy of RMI for the primary evaluation of ovarian masses in females presenting at a local tertiary care hospital in Pakistan.</p> <p>Methods: This prospective observational study was carried out at the Gynecology outdoor clinic of Fouji Foundation Hospital, Rawalpindi, Pakistan. The study comprised 141 females admitted for surgical exploration of ovarian masses. Pre-operative USG evaluations of ovarian mass, menopausal status, and serum CA-125 levels were determined for all the patients. RMI was calculated and post-operative histopathology of resected ovarian masses was done in all the cases to confirm the diagnosis.</p> <p>Results: The sensitivity and specificity of CA-125 alone at a cut-off value of 35 U/ml was 67.64% and 83.17% respectively. Using a cutoff value for RMI at 200 U/ml, the specificity and sensitivity of CA-125 were 85.98% and 76.47%, respectively. The receiver operating characteristic curve revealed that RMI was a better discriminate than CA-125, ultrasound, and menopausal status alone.</p> <p>Conclusion: The RMI is a useful tool in the primary evaluation of ovarian masses. It can be used to differentiate between benign and malignant ovarian masses with high sensitivity and specificity. Suspected malignant patients can be referred to a gynecological oncologist for further management.</p>

Background and Aim: The COVID-19 pandemic caused by severe acute respiratory syndrome (SAR-CoV-2) had severe consequences and complications on the global health care system. Recent medical studies have been focused on the effect of COVID-19 pandemic on pregnancies outcomes especially early pregnancies. The present study aimed to investigate the impacts of the COVID-19 pandemic early-trimester pregnancies. Materials and Methods: This retrospective study was carried out on 76 women who visited Obstetrics and Gynecology department for the first and second-trimester viability scan at Government Hospital, Samnabad Lahore from 1st January 2021 to 30th June 2021. Individuals of age between 19 years and 40 years with a diagnosis of spontaneous miscarriage were enrolled in this study. Ethical approval was taken from the respective hospital's ethical review committee. Patients with recurrent pregnancy loss, induced miscarriage, and other co-morbidities were excluded. All the demographic details were taken from the hospital medical record. All the patients underwent routine baseline tests to confirm the COVID-19 history and its impacts on the early trimester of pregnancy. The outcomes of early trimester pregnancy were viable pregnancy, miscarriage, pregnancy loss, and ectopic pregnancy were calculated in terms of frequency and percentage. SPSS version 20 was used for data analysis. Results: The overall mean age study group patients was 28.72± 3.63 years. The control group comprised 57 pregnant women with a gestational age of 5 weeks to 11 weeks, and the mean maternal age was 34.83±4.91 years. Out of total pregnant women, 31 (40.7%) were of age 19-25 years old, 29 (38.2%) had age 25 to 30 years, and 31 to 40 years were 16 (21.1%). Of the total 76 pregnant women, about 41 (54%) had a miscarriage with positive COVID-19 tests and 24 (31.6%) had spouses who had COVID-19 positive tests. History of both spouse and personal positive COVID tests were eleven patients (14.4%). The incidence of miscarriage among control group was 10 (17.5%). Conclusion: Our study found that the COVID-19 pandemic significantly affects the rate of pregnancy loss during the early trimester (first and second pregnancy). The maternal viremia or vertical transmission caused early trimester pregnancy loss and maternal infection during COVID-19. Keywords: Pregnancy, Miscarriage, COVID-19 Pandemic

<p><strong>Background and Objective:</strong> The use of autologous rectus sheath as a sling to correct uterovaginal prolapse in the younger age group has promising results. As this is an infrequently performed procedure in our country, hence this study aimed to assess the effectiveness of using autologous rectus sheath in young patients presenting with uterovaginal prolapse.<br /><strong>Methods:</strong> A prospective study was conducted at Bakhtawar Amin Trust Teaching Hospital in Multan, Pakistan in which 21 female patients who underwent uterine conservation surgery by using autologous rectus sheath during a period of 2 years were included. All these patients were followed up at 1 week and 6 months after surgery for any recurrence or other complications.</p> <p><strong>Results:</strong> The mean age of the patients was 47.09 &plusmn; 10.17 years. According to the pelvic organ prolapse quantification classification, 38.1% of patients had first degree, while 61.9% of patients had second-degree prolapse. After surgical correction, only one patient presented with first-degree uterine prolapse during follow-up while no post-surgical complication was reported in the rest of the patients with success rate of the procedure being 97.5%.<br /><strong>Conclusion:</strong> Uterine conservation surgery using an autologous rectus sheath as a sling for uterovaginal prolapse is an effective method of surgery and cost-effective technique in women seeking uterine conservation in developing countries.</p>