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Funding Acknowledgements Type of funding sources: None. Introduction : Syncope is the sudden loss of consciousness, associated with an inability to maintain postural tone, with immediate and spontaneous recovery without requiring electrical or chemical cardioversion. It is a common condition associated with frequent hospitalization or visits to the emergency department. It has a prevalence of 40%, considering a lifetime of 70 years and an annual incidence of 6%. The prognosis after syncope ranges from relatively benign for vasovagal to poor for ventricular tachyarrhythmia, but invariably creates anxiety and potentially life-changing disruption demanding timely resolution Overall, morbidity and mortality in syncope patients are low, but 1-year mortality can reach significantly higher in certain subgroups. Purpose : To compare the mortality rates in men and women so that management of the disease and comorbidities can be done accordingly. Methods : Anyone who presented to the ED with transient loss of consciousness (TLOC) between 2015 and 2018 (n = 11,718) underwent evaluation for syncope. Initial evaluation included history, physical exam, orthostatic blood pressure, heart rate measurement and a 12-lead ECG with or without echocardiogram. All patients were followed up from their initial ED visit until either April 30, 2019, or death, whichever occurred first. Results : Among the patients who presented to the ED, 1,011 (8.62%) females and 1,391 (11.87%) males were admitted to inpatient facilities. The median age of females at the time of diagnosis was 49 years as compared to 54 years for males. Moreover, females had fewer comorbidities (67.9% with Charlson/Deyo comorbidity score of 0) as compared to males (61.8% with Charlson/Deyo comorbidity score of 0). At 30 days, among those admitted, females had a mortality rate of 2.2% vs. 5.1% for males, and among those discharged, females had a mortality rate of 0.1% vs. 0.6% for males (P < .001 for both). At 1 year, among those admitted, females had a mortality rate of 10.9% vs. 15.6% for males, and among those discharged, females had a mortality rate of 1.8% vs. 3.2% for males (P < .001 for both). All data were analyzed on SPSS version 20 and it was found that males had a 1.2 fold greater risk for death at 1 year compared to females. Conclusion : By comparing the mortality rates of males and females presenting in the emergency department with syncope, we concluded that the mortality rate is higher in males. This finding will help us to manage the high-risk patients of syncope accordingly.

Objective: To analyse causes of maternal deaths and to identify preventable causes leading to this tragedy in our setup. Design: An analytical, hospital-based study. Place and duration of study: Department of Obstetric and Gynaecology, Nishter Hospital Multan from June-August 2005. Patients and methods: During the study period retrospective data was collected for period of 10 year from January 1995 to December 2004. This data was analyzed in order to determine the Maternal Mortality Rate (MMR), causes of death and characteristics of the mothers who died including her age, parity and whether they were booked or unbooked. Results: A total numbers of 30031 deliveries took place during the study period and there were 178 maternal deaths with maternal mortality rate of 593/100,000 LB (live births). 7(3.9%) patients were below the age of 20, 74(41.5%) were in the age group of 21-30 and 82(46%) in 31-40 years age range. 15(8.42%) were above the age of 40. Most of them (69%) were grand multiparas (Parity >5). The major causative factors were haemorrhage 63(35.4%), eclampsia 41(23.03%), sepsis 25(14.04%), anaemia 18(10.1%), hepatic encephalopathy 14(7.9%), abortion 11(6.2%). Majority of the patients were unbooked and presented in the hospital very late. Conclusion: A high proportion of potentially preventable maternal deaths indicate the need for improvements in education for both patient and health care provider. The provision of skilled care and timely management of complications can lower maternal mortality in our setup.

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Objectives: The objective was to determine the frequency of common factors leading to Primary postpartum hemorrhage. Study Design: Cross-sectional study. Setting: Study was conducted in obstetrics and Gynaecology ward of Nishtar Hospital Multan. Period: From 15-9-2017 to 14-03-2018. Material and Methods: Total 2119 deliveries were done in hospital during study period. Patients with loss of blood greater than 500 ml in vaginal delivery and 1000 ml in abdominal delivery were included. Main variables of study were age, paity, duration of delivery, mode of delivery. analysis was done by using SPSS for Window (version 10.0) Mean and stranded deviation was calculated for numerical data like ages of the patients and parity, while frequencies and percentages was calculated for qualitative data like mode of delivery. Results: 61.07% of the patients delivered vaginally and duration of labour was prolonged in 27.51% of cases. The single most frequent factor leading to primary postpartum haemorrhage was uterine atony i.e. in 48.99% of cases. Conclusion: Uterine atony was the most significant risk factors of primary postpartum haemorrhage. Our findings confirm the importance of previously recognized factors. Timely identification & management of these factors can help in reducing the incidence of maternal deaths.