IntroductionNeonatal mortality is a major challenge in low-middle-income countries. The current study was conducted to assess the association between preterm cesarean delivery and fetal outcomes. MethodsA prospective study was conducted at the Combined Military Hospital in Peshawar, Pakistan, from October 1, 2020, to March 31, 2021. All women reporting to the hospital with a cephalic presentation and singleton pregnancies between the 27th and 34th weeks of gestation were included in the study. Pregnancies with an abnormal presentation, those diagnosed with a congenital abnormality, and those with indications for growth restriction or preterm delivery were excluded from the study. We also excluded infants delivered via vacuum or forceps. The outcomes of interest in this study included neonatal death prior to discharge, neonatal respiratory distress, sepsis, intraventricular hemorrhage (IVH), seizure, subdural hemorrhage (SDH), or appearance, pulse, grimace, activity, and respiration (APGAR) test score of less than 7 at five minutes. Maternal features including diabetes, hypertension and gestational age of delivery, parity, previous cesarean sections (CS), and last pregnancy outcomes were documented in a predefined pro forma. ResultsOur sample size consisted of 288 women, who were classified into two groups. Group A comprised 144 women who gave birth vaginally and group B consisted of 144 women who underwent CS. It was observed that women who underwent cesareans had a higher likelihood of a history of hypertension and related pathologies. It was also observed that these women had a greater likelihood of being of higher age compared to women who underwent vaginal deliveries. Neonates of women who had CS were at a greater risk of presenting with respiratory distress than those who had spontaneous vaginal deliveries. ConclusionBased on our findings, respiratory distress was significantly more common in babies of women who delivered via CS. However, there was no difference in neonatal outcomes in terms of IVH, seizures, SDH, and APGAR score of <7.

Objective: The aim of this study is to determine the prevalence of diabetes mellitus and impaired glucose tolerance in patients with COVID-19. Study Design:Cross-sectional study Place and Duration:Conducted at department of Medicine, Khyber Teaching Hospital (KTH),Peshawer and Avicenna Teaching Hospital, Lahorefor the duration from July 2020 to December 2020. Methods: There were one hundred and fifteen patients of both genders had coronavirus disease were included in this study.Patients ranged in age from 25 to 80 years.After obtaining informed written permission, we collected detailed demographic information on all of the registered patients, including their age, gender, BMI, educational attainment and place of residence. All of the patients had their blood tested for corona disease using RT-PCR. After screening positive (fasting capillary glucose >100 mg/dl and 200 mg/dl) and each sixth consecutive negative (fasting capillary glucose <100 mg/dl) subjects, the 75-g oral glucose tolerance test was administered. The SPSS 23.0 software was used for analyzing of data. Results:Included patients had mean age 59.4±12.55 years with mean body mass index 29.12±11.76 kg/m2. There were 70 (60.9%) male patients and 45 (38.1%) females. Majority of the patients were illiterate 65 (56.5%) and 49 (42.6%) patients were from urban areas. Most common co-morbidities were hypertension, hyperlipidemia, chronic kidney disease and coronary artery disease. We found 62 (53.9%) patients had diabetes mellitus in which majority of the cases were pre-existing. Frequency of impaired glucose tolerance was found among 26 (22.6%) cases in which majority of the cases had pancreatic cancer. 28 (24.4%) cases had intubation. Overall mortality was found among 18 (15.3%) cases. Conclusion:This research found that people with diabetes and poor glucose metabolism are more likely to have severe Covid-19. A previously undiagnosed symptom of primary infection has been linked to a disorder in glucose metabolism. Pathways through which SARS-CoV-2 affects glucose metabolism must be investigated if disease aetiology is to be fully understood. Keywords:Coronavirus, DM, IGT, Co-morbidities, Mortality

Objective: To determine the frequency of pregnancy induced hypertension in teenage pregnancy, presenting in a tertiary care hospital. Design of the Study: It’s a descriptive case series Study Settings: This study was done at Department of Gynaecology & Obstetrics, Ziauddin Hospital, Karachi from January 2021 to June 2021. Material and Methods: Total 163 women with gestational age 20 and more weeks, age 10 to 19 years, singleton pregnancy, and with any parity were included in the study. On the basis of clinical examination, pregnancy comprised hypertension was diagnosed. If any patient had BP equal or more than 140/90 on more than two separate occasions, then it was considered as hypertensive. Patients were followed at 24, 28, 34, 36, and 38 weeks till delivery to look for development of Pregnancy induced hypertension. If patient developed any complications, was admitted and managed accordingly. By using computer program SPSS-17, data was entered and analyzed. For post stratification Chi-square test was applied and p-value ≤0.05 was considered as significant. Results of the Study: The average maternal age was 16.53±1.94 years. The mean parity was 3.03±1.44 and mean gravidity was 2.80±1.44. The mean gestational age was 31.17±3.52 weeks, with range 16(21–37) weeks. Age of 49 women was ≤15 years and age of rest of the 114 women patients was >15 years. The parity of gravidity of 113 women was ≤3 and it was >3 in 50 women. The parity of 131 women was ≤3 and in the 32 women it was >3. The gestational age of 73 women was ≤30 weeks and gestational age of 90 women was >30 weeks. The pregnancy induced hypertension was found in 24(14.7%) females who are expecting involved in the research. Among women with PIH the mean age was 16.46±2.14 years and mean gestational age was 30.83±3.26 weeks. The results showed no statistically significant association of maternal age, gravidity, parity, and gestational age with pregnancy induced hypertension. Conclusion: For higher incidence of pregnancy induced hypertension, the younger maternal age is a significant risk factor. Keywords: Pregnancy Induced Hypertension, Teenage Pregnancy, Frequency