Urdu is the national language of Pakistan and more than 100 million people speak Urdu worldwide. Urdu has 43 phonemes, however, there are some distinct phonemes in English and Urdu languages that affect the accuracy of test results. Ultimately, it leads to difficulty in assessment, diagnosis and intervention planning. This study is aimed to develop a criterion based articulation screening tool to identify articulation errors in Urdu speaking school going children. For this purpose, 500 Urdu words were selected after literature review for eliciting spontaneous single word responses at initial, medial and final positions. 10 professionals were requested to review and rate each word on a scale ranging from 1 – 5 (1=strongly disagree, 2= disagree, 3= neutral, 4=agree, 5= strongly agree). Pilot study was conducted on 25 Urdu speaking school going children to check content validity. The mean score of all the responses was calculated and the top three responses were selected for further application. In the second application, 200 school going children including 100 boys and 100 girls were included. Their responses comprising sound utterances at initial, medial and final positions were converted to mean scores. Mean scores of expert opinion, pilot study and final application of UAST were calculated using Excel spreadsheets. The minimum mean score of selected words was 3, whereas the maximum mean score was 5. Final application proves the validity of UAST. The minimum mean score of selected words was 4.5, whereas the maximum mean score was 5. The study proved that UAST is a valid screening tool to screen articulation errors in Urdu speaking school going children.

Objectives: To compare the safety and efficacy of uterovaginal packing and Foley’s catheter balloon tamponade in patients with excessive vaginal bleeding following vaginal delivery. Design : RCT ( Randomized Controlled Trial). Setting : Obstetrics & Gynaecology Deptt. , HFH ( holy family hospital) , RWP. Duration: Six Months. Materials & Methodology: 94 females who presented with excessive vaginal bleeding ( > 500 ml) following vaginal delivery, 18 to 40 years of age , gestational age (GA) ≥37 weeks were included. Patients with retained products of conception, PPH due to perineal, cervical or vaginal tear and coagulation disorders were excluded. The patients were distributed equally into 2 groups ; a and b based on the lottery method. Group a was managed with uterine packing and Group b was managed by the Foley’s catheter balloon tamponade. Efficacy and safety in both groups was measured. Results: In my study, efficacy was significantly high in uterine packing group (Group a) compared to Foley’s catheter balloon tamponade (group b) (89.36% versus 68.09%; respectively) with p-value of 0.012. In my study, safety was significantly high in uterovaginal packing group (Group a) compared to Foley’s catheter balloon tamponade (group b) (72.34% versus 31.91%; respectively) with p-value of 0.0001. Conclusion: Uterovaginal packing is more secure, prompt and efficient procedure to manage excessive hemorrhage after delivery compared to Foley’s catheter balloon tamponade. Keywords: Hemorrhage, uterovaginal packing ,foley’s balloon tamponade.

Female perineum is the tissue complex between the peritoneum and the skin that closes the pelvis inferiorly and its functionality depends on the interplay between organs, tissues, septae and spaces in it. It is a diamond-shaped region below the pelvic floor and extends between the pelvic diaphragm and the perineal skin. It is a surprisingly dynamic field with new insights, discoveries, and controversies and carries differences in viewpoint among anatomists and surgeons. This book chapter will provide an overview regarding perineal anatomy in the female and will focus on embryology, anatomy of the perineal region with modern proponents. It includes detailed anatomy of Urogenital and Anal triangles, their muscles with blood supply and innervation, anatomy and functions of the perineum, its role in Pelvic Organ Prolapse and clinical significance in urinary and fecal incontinence and contribution towards common obstetric and gynecological pathologies.

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Objective: To find out how commonly infections occur in cesarean section skin wound in post operative period and what factors are commonly encountered in these patients. Design: Descriptive Case Series. Setting: Obs & Gynae Deptt., Nishtar Hospital Multan (NHM). Duration of Study: Six Months. Subjects and Methodology: 121 patients undergoing cesarean section due to various reasons were enrolled in this research. These subjects were followed till 30 days of the procedure and examined through this interval for presence/absence of wound infection . These patients were evaluated for the presence of anemia, PIH/ pre-eclampsia, DM , PROM, obesity & type of cesarean section. Results: Age range was 18 to 45 yrs & Mean calculated i.e 28.289±2.74 years, mean gestational age 37.983±1.75 weeks, mean BMI 26.281±1.47 Kg/m2 and mean parity was 1.545±1.17. Post cesarean wound infection was seen in 9.9% patients. Factors leading to post-cesarean section wound infection were anemia found in 16.7%, diabetes mellitus in 16.7%, PROM in 16.7%, hypertension in 25%, obesity in 75%, emergency caesarean section in 75% and elective caesarean section in 25% were noted. Conclusion: Identification of causative factors of cesarean section wound infection, their correction and modification may help reduce wound infection rates among postoperative patients leading to reduction in maternal morbidity. Keywords: Cesarean section, Wound infection, Factors leading to wound infection.