Objectives: To determine the frequency and severity of depression and anxiety in patients who had undergone total abdominal hysterectomy with bilateral salpingo-oophorectomy. Study Design: A cross-sectional study. Setting: Department of Obstetrics and Gynecology, Isra University Hospital, Hyderabad, Sindh. Period: From 14th January 2015 to 14th January 2016. Material & Methods: Total 136 women were included in the study that had undergone total abdominal hysterectomy along with bilateral salpingo-oophorectomy. Women who had an obstetrical hysterectomy, vaginal hysterectomy, subtotal hysterectomy, hysterectomized women with pre-existing depression and psychosis and women who did not agree to participate were excluded. Anxiety and depression were labelled along with severity as per operational definition using Zung self-rating depression and Zung self-rating anxiety scale and were analyzed by using SPSS 11.0. Result: Majority of the women were married (88.2%), educated (66.9%), and grand multiparous (46.3%). Commonest age group was more than 40 years (29.4%). Anxiety was present in 27.2% whereas depression was seen in 32.4% women. Conclusion: There was a highly significant association of age, parity and level of education with anxiety as well as depression. Majority of the women suffered from mild to moderate level of anxiety and depression.

Objectives: To determine the frequency and severity of depression and anxiety in patients who had undergone total abdominal hysterectomy with bilateral salpingo-oophorectomy. Study Design: A cross-sectional study. Setting: Department of Obstetrics and Gynecology, Isra University Hospital, Hyderabad, Sindh. Period: From 14th January 2015 to 14th January 2016. Material & Methods: Total 136 women were included in the study that had undergone total abdominal hysterectomy along with bilateral salpingo-oophorectomy. Women who had an obstetrical hysterectomy, vaginal hysterectomy, subtotal hysterectomy, hysterectomized women with pre-existing depression and psychosis and women who did not agree to participate were excluded. Anxiety and depression were labelled along with severity as per operational definition using Zung self-rating depression and Zung self-rating anxiety scale and were analyzed by using SPSS 11.0. Result: Majority of the women were married (88.2%), educated (66.9%), and grand multiparous (46.3%). Commonest age group was more than 40 years (29.4%). Anxiety was present in 27.2% whereas depression was seen in 32.4% women. Conclusion: There was a highly significant association of age, parity and level of education with anxiety as well as depression. Majority of the women suffered from mild to moderate level of anxiety and depression.

Aim: To know about the prevalence, characteristic and nature of near miss events and to relate the nature of near miss events with that of maternal mortality. Study design: Descriptive cross sectional study Place and duration of study: Department of Obstetrics & Gynecology Unit IV, LUMHS Jamshoro from 1st January 2020 to 31st December 2020 Methodology: Pregnancy outcomes segregated into maternal death, near-miss event, or live birth categories. Age, level of education, religion, and residence were socio demographic variables. Obstetrics characteristics and nature of maternal near-miss events also studied. Result: The prevalence of maternal near-miss event was 5.6%, and the maternal near-miss events were seen more in multigravida, pregnant women with the lack of antenatal care in referral cases. Live birth as fetal outcome was 75%. The maternal death to near-miss ratio in this study was 1:5. 44 (42.3%) postpartum haemorrhage and 28 (26.9%), hypertensive disorders cases were leading cause of maternal near-miss events. Conclusion: Every fifth women who survived life-threatening complications, one died. Maternal near-miss should be adopted as an indicator for evaluating maternal health services. Keywords: Maternal near-miss (MNM), Maternal mortality, Life-threatening complication

Objective: The study's objectives were to evaluate the validity of the pipelle device in obtaining a suitable & representative endometrial sample by contrasting the histopathological outcomes of pipelle sampling with those from dilatation and curettage (D&C). Study design: An analytical cross-sectional study Place and Duration: This study was conducted at Liaquat University of Medical and Health Sciences Jamshoro from June 2021 to June 2022 Methodology: The study comprised 100 patients withabnormal uterine bleeding (AUB) who visited the obstetrics and gynecology department's outpatient clinic. Before a formal D&C, endometrial samples were taken from 100 patients using a pipelle device. The sample marked as sample A was obtained by inserting the Pipelle without conducting cervical dilatation and rotating it inside the uterus. The patients were then brought into the operating room for D&C, and the sample that was taken following D&C was designated as sample B Results: Pipelle sampling exhibited a 97% sensitivity,and a 100% specificity when compared to D&C sampling for obtaining an endometrial sample. With the exception of an endometrial polyp, which could not be detected by the pipelle sample, the Histopathology report’s diagnosis using the sample acquired from the pipelle showed very high sensitivity, specificity, positive predictive value, and negative predictive value. Conclusion: Pipelle endometrial biopsy is a risk-free method of obtaining an appropriate endometrial sample for histopathology. In terms of detecting endometrial abnormalities and endometrial cancer, it has high sensitivity and excellent specificity. An accurate diagnosis of endometrial cancer can be made using a Pipelle endometrial biopsy. Keywords: sampling, endometrial, abnormal uterine bleeding

Objective: The objective of this study is to find out the maternal mortality ratein our setup and found the preventable causes of maternal mortality rate. Design: Descriptivestudy. Place and duration of study: In obstetric ward of Liaquat university hospital Hyderabadfrom 10th Feb 2011 to 10th Jan 2014. Patients and Methods: All the women who were died dueto pregnancy complications were included in the study while women who were not died due topregnancy complications and maternal deaths due to accidental or incidental causes duringpregnancy were excluded from the study. Details of patient’s history especially age, parity,socioeconomic condition, reason of death, antenatal status, and distance from hospital wererecorded on predesigned proforma. Results: Total 48563 deliveries were conducted during thestudy period. Out of these, 103 women died, so the maternal mortality rate was 212.09/ 100,000live birth. Majority of women i.e. 43(41.74%) died; belong from age group of 31-40 years.Majority of women i.e. 78(75.72%) belonged to poor socioeconomic group and 83(80.58%)women had not received antenatal care. Most common cause of maternal mortality in thisstudy was hypertensive disorder which was seen in 43(41.74%) followed by APH in 39(37.86%)and PPH seen in 6(5.82%) patients .The most common cause of delay in seeking health carefacility was lack of transport reported by 43(41.74%) patients and familial taboos reported by36(34.95%) patients. Conclusions: Most important cause of maternal mortality in our studywas hypertensive disorders, APH and PPH. Maternal mortality was highest in advancing age,increased parity and in unbooked patients.