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BACKGROUND: Hemodialysis is the treatment of choice for end-stage renal disease but there is increasing evidence that dialysis patients have a high burden of problems including pain which may affect their quality of life. OBJECTIVES: The objective of this study was to find out the frequency of pain, its severity, and interference in patients receiving hemodialysis. METHODOLOGY: Data was collected from 218 patients from dialysis units of the Institute of Kidney Disease, Rehman Medical Institute, and Northwest General Hospital, Hayatabad Peshawar. A brief pain inventory questionnaire (BPI) was used to find out the frequency, severity, and interference of pain. RESULTS: The frequency of pain was 70.2%. The mean time period of treatment was 22.42 months (standard deviation (SD) 28.56). The pain was most commonly present in the lower limb. The calculated mean severity was 4.3 (SD 1.70) which showed most of the patients had mild pain. The mean interference of pain in general performance was calculated to be 5.6 (SD 2.10) which presented moderate interference. There was a significant correlation between mean pain severity and mean pain interference (P=0.000). Out of those 153 patients who reported pain, 119(77.78%) were taking medications for pain relief. CONCLUSION: Pain is a frequent problem reported by these patients. Out of those who had pain, greater than two third were taking medications for pain. Pain in these patients is the main cause of interference in the performance of general activities. So, it is important to manage the pain, and strategies other than medications should also be considered. KEYWORDS: Dialysis, End Stage Renal Disease, Hemodialysis, Interference, Pain

Rates of cesarean section (CS) are increasing globally; hence pregnancies with previous CS are also increasing at an alarming rate. This leads to increased complications in pregnancy such as morbidly adherent placentae, ruptured uterus and the rare complication of ectopic scar pregnancy. The aim of this case series is to highlight this serious complication and provide awareness to obstetricians. Early diagnosis and early treatment of cesarean scar ectopic pregnancies is essential to prevent maternal morbidity and mortality. Sonographic expertise is required to get the best results. Hemodynamically stable patients have many treatment options.

ackground: Induction of labor (IOL) is an obstetric intervention designed,usedin 20-30% of all pregnancies. The aim of this study was to assess the efficacy of oral misoprostol alone versus oral misoprostol and Foley’s catheter for IOL. Methods: All pregnant women age ≥18 years requiring induction of labor for various reasons and with unfavorable cervixes admitted in Ziauddin University Hospital Karachi are included in the study. Women were induced in “Group A” with an intracervical Foley’s catheter and tablet misoprostol 25 microgram given orally. In group B, women were given misoprostol 25 microgram tablets alone orally, subsequently every6 hourly for a maximum of four doses. Results: Normal vaginal delivery was significantly higher in group A (n=62, 59.6%) than that of group B (n=42, 40.4%) patients. Caesarean section was found higher in group B (n=25, 83.3%) patients than that of group A patients (n=516.7%; p-value